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 2: Multidisciplinary Care and Shared Decision-Making in Metastatic Hormone-Sensitive Prostate Cancer 
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Prostate cancer patients frequently have comorbid conditions that may impact life expectancy as well as the ability to tolerate prostate cancer-directed therapies. For older patients or those with multiple comorbidities, a formal geriatric or medical assessment may provide assistance for the clinician in making management recommendations. Relevant input into these complex issues may be best obtained by the involvement of which of the following: 
A 55-year-old, otherwise healthy patient with a PSA level of 43.21 ng/mL had a recent prostate needle biopsy which revealed prostate adenocarcinoma. According to pathology findings the patient is high-risk with a cT1c stage and Gleason grade 9 (G4+5=9). Computed tomography (CT) and bone scan results were negative. However, based on the patient’s PSA level and Gleason score, his urologist was highly suspicious of metastatic spread that was not readily identifiable with conventional imaging. What is the appropriate next step?
Genetic testing of a low-risk (Gleason 3+3 [Grade Group 1], PSA 4 ng/ml, cT1c N0 M0 stage) 45-year-old patient with localized prostate cancer and a family history of breast and ovarian cancer revealed the patient has a high-risk BRCA2 mutation. Given this patient’s profile which of the following monitoring/treatment approaches would be most appropriate? 
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