EAU15: 2nd ESO PCa Observatory shows perspectives in multidisciplinary approach

The speakers at the 2nd ESO Prostate Cancer Observatory, each representing a different discipline, prompted Prof. Karim Touijer (USA) to say that everyone is quite aware that there is much to gain from collaboration.”

We have to put our heads together, get out of our comfort zones and rethink the paradigm," said Touijer. Speaking as a urologist in a programme that featured a researcher, a medical oncologist, a radiation oncologist, a radiologist and a patient representative, Touijer stressed it is inevitable to work in a multidisciplinary manner.

"Urologists will play a central role in the managing PCa and they are going to start exploring -in a thoughtful and scientific way- the role of surgery in oligometastatic PCa. In other malignancies, we have seen great value in treating primary cancer through surgical excision," added Touijer.

The PCa Observatory, chaired by Prof. Valdagni (IT) on behalf of the European School of Ocology and Prof. Hein van Poppel (BE), invited speakers to look at innovation and care in the next 12 months.

Dr. Maria De Santis (AT) provided a medical oncologist’s perspective, and forecasted various treatment options in the coming year. "The TERRAIN study gives indications that suggest that bicalutamide will have a diminished role in PCa treatment," she said. She also cited the 2015 EAU Guidelines, which state that second hormonal manipulation is an option, but no longer mandatory to define the patient as being castration-resistant. Her comments triggered many questions from the audience.

Radiology

This year marked the first time a radiologist took part as a speaker, and Dr. Geert Villeirs (BE) was pleased to offer the radiologists’ perspective on PCa treatment. He pointed out that last year’s ESO PCa Observatory may have been a little optimistic with the outlook for 2015. Better targeting for biopsies, better stratification of aggressiveness, better N- and M-staging and better follow-up (more imaging, fewer biopsies) were very much in reach for the coming year. A better quantification of the tumour burden was still uncertain, and while dosage may improve, measuring the volume remains difficult.

Valdagni welcomed the particpation of a radiologist and told the EUT: "In the future, we will continue to invite a radiologist. Their role is becoming more and more important. Not only for the general evaluation of the patient, but specifically in local evaluation of disease, aggressiveness and targeted biopsy. The radiologist also follows patients in active surveillance."