Dr. Mack Roach on RT For Intermediate + High Risk Newly Diagnosed PCa

Dr. Mack Roach has been involved in clinical trials on the role of radiation therapy in the treatment of intermediate and high risk newly diagnosed prostate cancer. We recently asked him where he saw that area going in the future and what ideas excited him.

Dr. Roach said: “One area I’m excited about is the value of radiotherapy to stimulate the immune system, particularly in people with metastatic disease. I think another exciting area with a lot of potential is the use of robotics to do brachytherapy under real time MR guidance. One of the problems with brachytherapy is that while brachytherapy could be the least expensive way to treat prostate cancer it’s technically challenging to do a good job on a consistent basis. I think it would be exciting if you created a robotics system that ensured every implant was well done and were able to document that it was well done. I think some of the newer agents might have additional benefit. But primarily that would be for people who have very much advanced disease. I think some of the new molecular assays that help us determine which patients have lower risk disease and may not benefit from treatment are interesting. Using those assays, we could tailor aggressive treatment to the appropriate patient. We could determine whether people need hormone therapy or not. If they need hormone therapy, we could determine whether they needed short-term hormonal therapy or long-term hormonal therapy. Another exciting area is multi-parametric imaging that helps us selectively target areas of the prostate, allowing us to reduce the morbidity of treatment.”


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