Central Nervous System Effects and Treatment Selection in Metastatic Castration Sensitive Prostate Cancer (mCSPC)

In this segment, Dr. Charles J. Ryan invites Dr. Jayram and Dr. Alan H. Bryce to discuss how potential central nervous system effects influence treatment selection in metastatic castration sensitive prostate cancer (mCSPC). The conversation focuses on concerns such as cognitive changes, fatigue, and fall risk, which are particularly relevant for older patients receiving long term systemic therapy. Dr. Jayram highlights that clinicians increasingly consider how certain therapies may affect cognitive function and overall daily functioning, especially in patients who already have age related vulnerabilities or comorbid conditions. Dr. Bryce adds that maintaining independence and preserving quality of life are important goals when selecting therapy for patients expected to remain on treatment for extended periods. Both physicians emphasize the importance of discussing these potential risks with patients during shared decision making. The segment underscores how awareness of central nervous system related adverse effects helps guide individualized treatment strategies in metastatic castration sensitive prostate cancer.