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Genitourinary Cancers

In this review we will outline an approach to sequencing new therapies for metastatic castration-resistant prostate cancer (CRPC), with particular attention paid to the biology of CRPC.

Genitourinary Cancers

The addition of gemcitabine to a cisplatin- and ifosfamide-containing drug regimen resulted in a complete response rate of greater than 50% in patients with relapsed metastatic germ cell tumors, results of a phase II study indicated.

A 60-year-old man was incidentally found to have a large right renal mass during a CT scan with and without intravenous and oral contrast ordered by his primary care physician to evaluate mild right side abdominal discomfort and hepatomegaly.

This review will include discussion of the role of radiation therapy for osseous metastases and metastatic spinal cord compression, as well as the use of radiopharmaceuticals for painful osseous metastases.

As new data and new treatment options emerge, palliative radiotherapy algorithms will need to undergo continuous modifications and updates to ensure that patients receive optimal symptom relief.

Moving forward, perhaps no recent development in the use of RT in metastatic prostate cancer has captured greater attention than the use of radium-223 in metastatic castration-resistant prostate cancer (mCRPC).

It is important for all of us now and then to take a step back and recapture the wonder that we all felt at the onset of our careers, when treatments we now consider simple and routine held an aura of miracle. For me, a little bit of that wonder returns every time I treat a patient with a bony metastasis—in particular, from prostate cancer.

In order to achieve maximum survival of patients with metastatic castration-resistant prostate cancer, the judicious use of all available effective agents and modalities is required. Both EBRT and radium-223 are effective at relieving pain, but both may decrease bone marrow function.

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