Answers in a day: The team approach offers multidisciplinary
help for men with high-risk disease.
From left: Katarzyna Macura, Robin Gurganus, Kelly Cavallio,
Danielle Crump, Ted Deweese, Michael Carducci, Melissa Faust,
Alan Partin

The last thing a man with prostate cancer wants to do is wait to see a physician — particularly if he’s worried that his cancer may have spread beyond the prostate. Imagine the frustration, then, of a man diagnosed with “high-risk” disease, which may need more than one form of treatment. He has to talk to a surgeon, a radiation oncologist, and a medical oncologist, just for starters. He may also need to talk to other specialists, such as a nutritionist or an anesthesiologist, and just scheduling these visits can be a nightmare. He’s got one appointment set for the beginning of the month with one doctor, an appointment four weeks later with a second, and he’s hoping for a cancellation at a third doctor’s office; otherwise, he can’t be seen by that doctor for two more months.

How stressful. And how unnecessary. Men shouldn’t have to go through this, says Brady Director Alan W. Partin, M.D., Ph.D. “It takes some men three to six months to make their rounds, see different physicians, and make the decision about the best form of treatment for them. If you have high-risk disease, you often don’t have that kind of time. You should be able to make a logical decision, based on good advice.”

In May, the Brady Urological Institute began what Partin refers to as “one-stop shopping” — a multidisciplinary clinic for men with high-risk prostate cancer. The clinic meets weekly and between four and six men are evaluated. In the span of just a few hours, a man can meet with a top urologist, medical oncologist, or radiation oncologist. Then those doctors meet and review his case — including his pathology report, MRI, X-rays, and any other relevant materials — together, to come up with the best treatment plan.

“When there is a high probability that a man’s cancer may have gotten to the edge of his prostate, or spread beyond it, finding the right treatment can be a tough decision,” says Partin. “This team approach has been an awesome experience,” and it has been free of any medical turf battles. “We’ve had no problems coming to a conclusion.

“ It takes some men three to six months to make their rounds, see different physicians, and make the decision about the best form of treatment for them. If you have high-risk disease, you often don’t have that kind of time.”

It’s been very collegial. Then we give the options to the patient and his family, and they’re the ones who really make the decision.” So far, three urologists, three radiation oncologists, and four medical oncologists are seeing patients together.

Partin anticipates that the multidisciplinary nature of the clinic will foster unique studies and clinical trials involving new treatment combinations — surgery and chemotherapy, for example — and will contribute to ongoing work in understanding the genetics of prostate cancer, and in developing
new biomarkers to detect and monitor the disease.