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Royal (Hormonal-Resistance or Metastases Outside the Pelvic Nodes) is what defines Royal. Low-Royal is “pure” hormone resistance without any proven metastases. Hormonal resistance is defined as a rising PSA with a testosterone level less than 50. Basic- or High-Royal means that metastases outside of the pelvic nodes are proven to exist. With Basic-Royal the total number of metastases is five or less. Men with High-Royal have more than five metastases. Clearly, the likelihood of detecting metastases is influenced by searching with the best available type of scan. PET scans, for example, may convert men who were thought to be “Low-Royal” using an older type of scan technology to Basic- or High-Royal.
Treatment recommendations for Royal can vary widely because doctors are struggling to digest the explosion of new knowledge. Better treatments, improved scans and a deeper understanding of staging, genetics and immunotherapy have all conspired to complicate and increase the controversy about how to select optimal therapy. Overall, however, we can certainly be thankful for these breakthroughs and the additional discoveries that are coming in the near future.
“Like any other treatment decision we’re looking at risk-benefit ratios, we’re looking at what other options do we have?” LISTEN TO THE EPISODE For men with limited options, clinical trials …
COUNTDOWN. MARK YOUR CALENDARS. Have you subscribed the PROSTATE PROS podcast? Be one of the first to know about a new podcast release! Questions about prostate cancer you want to …
The PSMA PET Scan is changing the way doctors decide what treatments to recommend for prostate cancer. Accurate assessment of a cancer spread is essential. Until now, physicians estimated the …
Listen: https://soundcloud.com/prostate-oncology/the-intelligence-of-immunotherapy “We hope and believe that men with advanced prostate cancer are going to see greater longevity and a better quality of life [with immunotherapy]. Even now, immunotherapy is …
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How to Sequence Taxotere, Jevtana, Xtandi, and Zytiga By Mark Scholz, MD Since the advent of effective second-generation hormonal therapies such as Zytiga or Xtandi, prostate cancer experts have been …
BY MARK SCHOLZ, MD Hormones play a large role in cancer growth. They are also integral to treatment. Testosterone is a key player. It originates mostly in the testicles and, …
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BY MARK SCHOLZ, MD Unhealthy diets encourage prostate cancer’s growth and spread. Consider Asia, where mortality from prostate cancer is eighteen times lower than in the United States. Genetic factors …
When I was 10 years old, my mother lost a close friend to cancer. I was too young to know anything about serious illness, but when I asked her why …