ESTRO Course: Multidisciplinary Management of Prostate Cancer

It emphasises the importance of a multidisciplinary approach and of teamwork, where full information exchange is vital to provide the best up-to-date scientific evidence on which the management of the disease will be based. This will be illustrated during state-of-the-art lectures presented by experts in the field, covering important issues such as biology, imaging, pathology, therapy and future developments. Interactive case studies and journal clubs will be integrated on a daily basis and there will be ample time for open discussions amongst participants and experts. A special session on target delineation for radiotherapists will also be organised during the course.

Learning outcomes

• To provide an in-depth overview of the epidemiology, pathology, imaging and treatment options for low, intermediate and high risk prostate cancer
• To discuss patient selection/indications and contra-indications for the various treatment options
• To provide a critical overview of the surgical and radiotherapy techniques available for the management of prostate cancer
• To discuss the new drugs currently available for the management of the advanced and metastatic stages of the disease
• To debate on the most recent developments relevant to prostate cancer management.

Course content

• Normal prostate: anatomy – embryology, histology
• Prostate cancer: epidemiology and prevention, clinical diagnosis, imaging modalities pathology, staging
• Low risk prostate cancer: active surveillance, surgery and the postop pathology

• Radiotherapy and brachytherapy, the pathology after irradiation
• External beam radiotherapy: on-line control, target delineation

• High risk prostate cancer: radiotherapy and hormones, alternative radiotherapy regimens
• Toxicity of radiotherapy: acute and late morbidity – erectile dysfunction
• Role of surgery and its morbidity
• Alternative treatments
• Adjuvant and salvage radiotherapy after radical surgery

• Rising PSA after surgery and after radiotherapy
• Imaging for recurrent detection
• Node positive prostate cancer
• Metastatic prostate cancer: hormones and their complications

• Castration resistant prostate cancer: new drugs
• Palliative radiotherapy and surgery
• Non systemic treatment in the metastatic setting.
• Case Discussions

Prerequisites

Before commencing this course participants should:

• Revise the general principles of prostate cancer epidemiology, pathology, diagnosis and staging
• Read the published ESTRO and ASTRO guidelines on prostate contouring and the EAU/ESTRO/SIOG/EANM/ESUR guidelines on prostate cancer
• Complete the FALCON* exercise which is distributed prior to the course.

Teaching methods

• 21 hours lectures
• 3 hours contouring
• 4 hours practical workshops
• 5 hours interactive discussions.

The course consists of didactic lectures, interactive sessions (clinical case discussions and Journal Clubs) and practical demonstrations.

Methods of assessment

• In-class voting
• Delineation exercise