Until recently when a patient with prostate cancer was developing resistance to drugs that block testosterone, the hormone that fuels the cancer growth, his urologist would refer him to an oncologist who would start chemotherapy. The situation recently changed with the arrival on the market of new drugs such as sipuleucel-T, radium 223, enzalutamide, abiraterone, and cabazitaxel. These new drugs target so-called “castrate-resistant” patients and can be prescribed by either the urologist or the oncologist.
As of Today there is a lot of confusion about these new drugs. Urologists and oncologists are not clear on whether patients should be treated similarly or which drug should be used and in what order to be the most effective. The lack of communication between specialists as well as the financial incentive in keeping a patient as long as possible may be detrimental to the patient and may lead to medical malpractice.
In an article published Today in the Journal Urologic Oncology, urologist Ralph de Vere White and medical oncologist Primo Lara, Jr. of the UC Davis Comprehensive Cancer Center provide an in depth look at the situation and demonstrate that better guidelines and coordination between specialists are necessary to deliver cost effective and efficient care to patients with castrate-resistant prostate cancer (CRPC).