PCRI's Alex asks medical oncologist, Mark Scholz, MD, about metastatic prostate cancer, especially low-volume metastatic disease and de novo metastatic disease (meaning, newly diagnosed without prior treatment for prostate cancer). They discuss how PSMA PET scans are changing how we think about different disease states and whether it is possible in 2023 for a patient with early metastatic disease to achieve a cure or extended remission.

0:07 How does prostate cancer typically metastasize?

2:19 Prostate cancers are typically categorized by Gleason score, which represents a prostate cancer's level of aggression. At which Gleason score is metastasis possible? Do higher scores mean metastasis is more likely?

3:36 What constitutes "lymph node metastasis" in prostate cancer and how is metastasis different in prostate cancer compared to other cancers?

5:29 What kind of situation counts as "early stage metastatic disease" compared to advanced metastatic disease?

6:26 What is the meaning of "cure" and "remission" in prostate cancer?

6:56 De Novo Metastasis: Is there a possibility of achieving a cure after metastasis has occurred?

8:11 People tend to have a negative perception of chemotherapy; however, in prostate cancer, the most commonly used chemotherapies, Taxotere and Jevtana, and relatively well-tolerated. Can you explain how chemotherapy in prostate cancer compares and contrasts with more intense forms of chemotherapy in other cancers?

10:31 What does "oligometastatic disease" mean?

11:38 Bone pain is a common symptom of metastatic prostate cancer in the bones. Can you explain how that symptom would develop or how it might be distinguished from other bone pains?

13:37 Is PSMA PET scan the best body scan to look for metastases? Should a person still get a bone scan in 2023 if PSMA PET scans are available?

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