Improving the Overall Safety and Quality of Care for Your Patients with Metastatic Hormone-Sensitive Prostate Cancer: How Does Your Approach Compare with the Experts?

Podcast 1: Improving the Quality of Care for Patients with Metastatic Hormone-Sensitive Prostate Cancer Using Evidence-Based Guideline Recommendations
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A 68-year-old male with a history of chronic obstructive pulmonary and type 2 diabetes with grade 2 peripheral neuropathy presented to his primary care physician with reports of difficulty urinating and low back pain. Blood work revealed that his prostate-specific antigen (PSA) level was 47.5 ng/mL. The patient was referred to a urologist who performed a prostate needle biopsy, which revealed a prostate adenocarcinoma. Pathology findings included cT3 stage and Gleason grade 9 (G4+5=9) in all biopsy cores sampled. Subsequent bone scan detected 3 bone metastases in the lumbar spine and 2 bone metastases in the right pelvis. The patient was diagnosed with metastatic hormone sensitive prostate cancer (mHSCP). Which of the following treatment options is most appropriate for this patient? 
Recent NCCN guidelines for prostate cancer strongly recommend androgen deprivation therapy (ADT) with treatment intensification for patients with metastatic castration-sensitive (or hormone sensitive) prostate cancer. Treatment intensification options for men with de novo metastatic disease include:
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