Dr. Yu on Comorbidities and Therapy Choice in Prostate Cancer

Evan Y. Yu, MD, professor, Department of Medicine, Division of Oncology, University of Washington, Seattle Cancer Care Alliance, discusses how comorbidities factor into treatment choice for patients with castration-sensitive prostate cancer.

Comorbidities are an important factor to consider, says Yu. Other factors include duration of therapy and financial toxicity. Docetaxel has a unique side effect profile with neuropathy and hepatic issues. Patients may need to take high doses of steroids prior to treatment to combat these side effects. An upside, says Yu, is that patients do not have to take chronic steroids.

In trials of patients with metastatic castration-resistant prostate cancer, Yu notes that patients were given 5 mg of prednisone twice a day. Whereas, patients in the CHAARTED trial did not receive prednisone. Patients who received abiraterone acetate (Zytiga) got lower doses of chronic steroids, which may be a consideration for a patient who is a brittle diabetic, says Yu. Ultimately, there are multiple considerations that may push physicians one way or another.