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Charles Ryan: One of the astir important advances successful the attraction of men with prostate crab is treating the diligent alongside treating the cancer. Helping patients unrecorded better, helping patients beryllium supported successful different organs of their body, done different attraction types. And we telephone this crab survivorship. And prostate crab is truly a lawsuit survey successful survivorship due to the fact that galore patients unrecorded a precise agelong clip aft the diagnosis portion receiving treatment.
So, the Prostate Cancer Foundation has been progressive successful prostate crab survivorship for rather immoderate time, and I'm delighted contiguous to beryllium joined by 2 pioneers successful the country of prostate crab survivorship. Dr. Matthew Smith, who's a Professor of Medicine astatine Harvard Medical School and a Medical Oncologist astatine Massachusetts General Hospital. And Alicia Morgans, who is simply a Genitourinary Medical Oncologist astatine the Dana-Farber Cancer Institute. So congratulations some of you connected establishing the paradigm of survivorship successful prostate cancer. And I privation to commencement with you Matthew, you were truly 1 of the aboriginal pioneers successful establishing this conception and focusing, I deliberation astatine archetypal connected bony health. Tell america a small spot astir however that communicative developed and what strides we've made successful the discourse of treating bony wellness successful men with prostate cancer?
Matthew Smith: Happy to bash so. So men are surviving longer with prostate crab and they're surviving longer, but with a greater load of the consequences of treatment. And successful 1997, we had an thought erstwhile I joined the module to look astatine the contented of the effects of androgen deprivation therapy, the astir commonly administered systemic attraction for prostate crab connected the semipermanent health, short- and semipermanent wellness of men with this disease. And the thought was there, but we had a truly hard clip getting enactment for it until we partnered with the Prostate Cancer Foundation and they funded 1 of our archetypal trials. And that was designed to look astatine the effect of androgen deprivation therapy connected bony nonaccomplishment and besides to look astatine an involution to forestall bony nonaccomplishment astatine the aforesaid time. And that archetypal concern successful that enactment has led to this tremendous assemblage of lit and of knowing that we present telephone prostate crab survivorship.
Charles Ryan: I volition accidental that that's been a tremendous alleviation of the load of fractures, of adjacent pain, and different arenas. Give america a consciousness of the scope of the payment that men present person from bisphosphonates and RANK-ligand therapy, and I would accidental adjacent conscionable a greater consciousness of bony health.
Matthew Smith: Yeah, astatine the clip we began that work, determination was a batch of misunderstanding. There was this wide presumption that osteoporosis and fractures bash not hap successful men. This is of people untrue. And androgen deprivation therapy and different forms of prostate crab treatment, portion they've dramatically improved crab outcomes besides person imaginable antagonistic effects connected the wellness of our patients with prostate cancer. So we've present demonstrated done that and consequent work, that we tin forestall bony nonaccomplishment and fractures during androgen deprivation therapy for prostate cancer. There's been consequent designation that the different therapies that we administer pursuing androgen deprivation therapy besides accrued hazard of falls and fractures, highlighting the value of this field. And 1 of the unintended benefits of this aboriginal PCF enactment is, successful studying bony nonaccomplishment we besides studied different impacts of androgen deprivation therapy successful that aforesaid archetypal survey and recovered that men suffer muscle, summation abdominous and person antagonistic effects connected predictors of cardiovascular illness risk. So that, again, archetypal enactment looking astatine bony nonaccomplishment led to this overmuch broader assemblage of knowing of the impacts of androgen deprivation therapy.
Charles Ryan: So that's the root communicative of the speech that I person with patients each the clip present erstwhile I'm putting them connected androgen deprivation, bony health, cardiovascular health, et cetera. So, Alicia, you're present starring a survivorship clinic, a survivorship programme astatine the Dana-Farber, and this is focusing connected men with prostate cancer. How are you moving that connection into your attraction of men who are receiving androgen deprivation therapy successful today's world?
Alicia Morgans: Sure. So the programme really takes attraction of each crab patients successful the center. We person circumstantial emphasis, of course, successful GU for patients with prostate cancer, and we effort to enactment it successful by talking astir immoderate of those cardinal factors that you've already mentioned. So truly an accent connected bony wellness and an accent connected cardiovascular health. And the changes successful reversible cardiovascular hazard factors that hap successful the mounting of androgen deprivation therapy.
One happening that's inactive successful process successful our clinic, and I deliberation that is besides inactive successful process crossed clinics astir the satellite probably, is ensuring that this is simply a standardized and structured conversation. Because without that standardization, it's truly casual to hide 1 oregon 2 components oregon possibly each of it successful a engaged session visit. So ensuring that there's possibly adjacent a checklist oregon circumstantial visits to absorption connected these complications of androgen deprivation therapy, I deliberation is truly important. And touching connected each of those things that we request to bash successful presumption of hazard assessment, addressing reversible hazard factors for cardiovascular disease, and addressing bony and cardiovascular health.
Charles Ryan: Matthew, arsenic we look to the future, what are the existent unanswered questions astir bone-targeted therapy, bony wellness successful men with prostate cancer? What much bash we person to bash for them?
Matthew Smith: Well, I deliberation a batch of it has to bash with acquisition and implementation. So we person the evidence, we cognize that this is simply a occupation successful men with prostate cancer. It's worsened by androgen deprivation therapy. And past arsenic I alluded to earlier, consequent therapies, AR pathway inhibitors, galore of them further summation the hazard for falls and fractures. And yet this is not wide implemented therapy. And astir studies, adjacent astatine world aesculapian centers, successful prospective objective trials, comparatively fewer patients are being advised astir this oregon offered these interventions. So contempt recognition, wide designation is simply a problem, the existent implementation of preventative therapies for fracture hazard simplification person yet to occur. As we look to the future, we request to absorption connected 2 things. One is implementing what we already understand, and that is to use the therapies and interventions that we cognize tin forestall complications of prostate crab treatment. We besides person a much broad knowing of different adverse effects of therapy for our prostate crab survivors.
Alicia Morgans: We look guardant to partnering with the Prostate Cancer Foundation connected the contented of survivorship to assistance instrumentality a standardized attack to prostate crab survivorship that tin beryllium disseminated crossed each clinics. An attack to cardiovascular wellness and knowing reversible hazard factors and an knowing of bony wellness and ways that we tin intervene connected that to guarantee that patients tin not lone place complications of survivorship, but forestall them successful the future.
Matthew Smith: I look guardant to partnering with the PCF connected continued enactment successful prostate crab survivorship. The PCF was instrumental successful establishing this tract of innovation and research, and truly improving the lives of our patients with prostate cancer. The absorption connected survivorship with PCF truly makes a prostate crab diagnosis a teachable moment. This is not lone astir a patient's prostate crab diagnosis, but a wide designation of their wide wellness and the interaction of attraction connected those different wellness issues, including bony nonaccomplishment and fractures, cardiovascular illness risk, and hazard for diabetes and different conditions.
Alicia Morgans: What this means for patients is that we not lone absorption connected your prostate crab and ensuring we person bully illness control, but we absorption connected each of you. Keeping your bosom healthy, your bones healthy, and keeping you mentally capable to woody with the challenges ahead.
Charles Ryan: Well, convey you some to Dr. Matthew Smith and Dr. Alicia Morgans, who person established the paradigm of survivorship successful prostate cancer. Have established the request to code the carnal and intelligence and affectional needs of the full diligent who's undergoing therapy. And we look guardant to your continued enactment with the Prostate Cancer Foundation successful this truly important topic.
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