At the recent 2011 Prostate Cancer Research Institute Dr. Mark Scholz discussed care issues for men with advanced metastatic prostate cancer. In his presentation he stressed the importance of closely monitoring each man’s individual, on-going response to treatment to determine its effectiveness. He made a case that without close monitoring; treatment decisions would lag behind disease state.

Dr. Scholz said that he believes that it is important to change treatments after 60-90 days if there hasn’t been an adequate response, or if there are excessive side effects. He suggested
the following monitoring benchmarks:

• Changes in pain
• Checking PSA, PAP, LDH, ALP every 2-4 weeks
• Checking circulating tumor cell levels monthly
• Getting a PET scan after three months
• Having bone scans (CT, MRI) every 6 months

Dr. Scholz also indicated that he believes that Taxotere (chemotherapy) should be used in combination with another active agent. He said that combination therapy is much more
effective than using Taxotere alone. He indicated that in his practice he has found the effective combination therapeutic agents (with Taxotere) include Carboplatin, Carboplatin (Xeloda), Avastin and Custirsen.

He also said that treatment decisions should be personalized. Patients with slowly progressing disease should use milder single-agent therapy. Those of us with more aggressive disease need to use combination therapy.

Joel T. Nowak, M.A., M.S.W.