"I’d like to see new guidelines on the management of advanced prostate cancer. Right now, there’s kind of a gap in the treatment of advanced prostate cancer once patients have become hormone refractory. Some of the medications are only FDA approved if patients have proven metastatic prostate cancer. So we have some men who are in a gap where their PSA is rising, but they don’t necessarily have a treatment for that.
Even though these treatments would be beneficial for before metastasis, they aren’t necessarily used off-label because insurance companies won’t pay for them and they cost $4,000 to $5,000 a month. If the AUA came up with practice guidelines on when and how to treat men with advanced prostate cancer as they progress, those medications could then potentially be covered by insurance.
It’s a work in progress because there are newer medications that have been developed and released in the past 6 months that are FDA approved for that indication but the AUA has not endorsed them. So whether they are FDA approved or not, they need to be considered by the AUA. I’d like to see the treatments that are FDA approved added to the AUA guidelines.
And I think it would be beneficial to get AUA guidelines for earlier use of the newer agents for advanced prostate cancer, that are not FDA approved for those nonmetastatic patients. That could help them get the FDA approval sooner.”
Rodney Smith, MD