Guidelines for Treating Prostate Cancer with Dr. Bill Vanasupa

In this video, Dr. Bill Vanasupa, a board-certified urologist, discusses the different risk categories for prostate cancer and their corresponding treatment recommendations. The risk categories are very low, low, intermediate (favorable and unfavorable), and high.

Dr. Vanasupa emphasizes that these are just guidelines and that patients have the option to decline any recommended treatment. He gives an example of a patient with intermediate risk on favorable disease who chose to undergo radiation alone without hormone therapy, even though the latter was recommended, due to the potential adverse effects and his job.

The doctor also explains that he gives patients a month to consider their options and undergo any necessary tests before discussing treatment as a team to achieve the best outcome.

One of the main takeaways from this video is the importance of informed decision-making when it comes to prostate cancer treatment. While medical professionals can offer guidance and recommendations based on the latest research and guidelines, ultimately, the patient should have a say in their treatment plan.

Another key point is the need to weigh the potential benefits and risks of different treatment options, as well as their impact on the patient’s quality of life. In the case of the patient mentioned by Dr. Vanasupa, for example, hormone therapy may have been the recommended treatment, but its adverse effects and the patient’s job made radiation alone a more viable option.

Overall, Dr. Vanasupa’s approach to prostate cancer treatment is patient-centered and collaborative, emphasizing the importance of open communication and shared decision-making. By taking the time to educate patients on their options and involve them in the decision-making process, he aims to ensure that they receive the best possible care tailored to their individual needs and preferences.

TRANSCRIPTION:

My name is Bill Vanasupa.

I am a board certified urologist at Advanced Urology Institute in St. Augustine, Florida.

It depends on their risk certification.

Right now there is very low risk, there’s low risk, there’s intermediate risk which

is subdivided into favorable and unfavorable and there’s high risk.

Each risk category has its own recommendations and these recommendations have been brought

forth by the American Urologic Association and so I take patients through all the guidelines

and recommendations.

I tell them these are just guidelines and if you don’t want to do or to follow these

guidelines you don’t have to.

And so I have patients who say have intermediate risk on favorable disease where he wants to

do radiation and I tell them it should be radiation with hormone therapy but hormone

therapy has its own adverse evidence as well and risk of that treatment and after discussing

that he didn’t want to do that so he’s going to have radiation alone without the

hormonal treatment.

Knowing that it is recommended but with his job is something that he does not want to

be treated with and so again every risk category has its own recommendations and I just go

through them.

I generally give patients a month to just take it over.

If there’s any imaging or blood tests that needs to be done that’s done within that

month and then we come back, sit down again and discuss what we want to do as a team to

make sure that this patient gets the best outcome that he wants.

References:

• “Prostate Cancer Treatment (PDQ®)–Patient Version – NCI.” 16 Feb. 2023, https://www.cancer.gov/types/prostate/patient/prostate-treatment-pdq.
• “Prostate Cancer: Risk Factors and Prevention.” https://www.cancer.net/cancer-types/prostate-cancer/risk-factors-and-prevention.
• “Risk Groups for Localized Prostate Cancer.” https://www.cancer.org/cancer/prostate-cancer/detection-diagnosis-staging/risk-groups.html.