Luis Carrascosa, MD, a radiation oncologist at the Florida Cancer Specialists Ocala Cancer Center, discusses new and upcoming trends in radiation therapy for prostate cancer.
Luis Carrascosa, MD, a radiation oncologist at the Florida Cancer Specialists (FCS) Ocala Cancer Center, discusses new and upcoming trends in radiation therapy for prostate cancer.
FCS works to stay at the forefront as new therapies are developed and approved. Are there any new or developing treatments in radiotherapy that you foresee improving patient outcomes and/or saving on costs?
There's a trend in radiation oncology treatments not only for prostate, but in a lot of other areas—lung cancer, breast cancer, and many other sites—in which we are now reducing the number of treatments. So we are doing stereotactic techniques, which give very high doses of radiation to a very small, precise area. That's definitely one of the ways that radiation is changing.
Other things that are coming along are, for example, all of our radiation treatment delivery is based on CT scan planning, and that’s a very good way of doing it. But there are some newer radiation machines that are having an MRI-based planning, so you're doing an MRI at the same time that you're doing the radiation. That's definitely something that is going to be very important in the future.
We're also looking at incorporating different tests. Recently, there are some newer agents for prostate cancer, specifically PSMA [prostate-specific membrane antigen] PET [positron emission tomography] scanning, which has been FDA approved but is still not commercially available. But we're moving in the direction of better imaging techniques and things that are going to potentially improve the way that we individualize radiation and how we give radiation to patients. There's a lot of exciting things coming.
Another recent development in prostate cancer treatment just this year has been approval of PARP inhibitors for certain prostate cancer types. Do you see potential for utilizing targeted therapies in combination with radiation therapy as you look forward?
PARP inhibitors have been used in other types of cancers—for example, ovarian cancer—in which there are certain genetic changes, and so the same thought process has been applied to prostate cancer, and there's certain PARP inhibitors that are being utilized. For prostate cancer in some scenarios, we're entering into an era in which we are exploring how all these new agents are going to combine with radiation. We see a lot of potential for some of these targeted therapies or immunotherapy, and how to incorporate all of these newer agents with radiation. We think there's really good potential that we could improve outcomes with those combinations. Trials are going on, but there's a lot of potential.