{"id":6,"date":"2013-12-22T23:30:11","date_gmt":"2013-12-22T23:30:11","guid":{"rendered":"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/?page_id=6"},"modified":"2021-03-08T18:24:59","modified_gmt":"2021-03-08T18:24:59","slug":"psa-recurrence","status":"publish","type":"page","link":"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/psa-recurrence\/","title":{"rendered":"Treatment of Advanced (PSA recurrence) and Metastatic Prostate Cancer in NYC and Brooklyn"},"content":{"rendered":"<h1>Treatment of Advanced (PSA recurrence) and Metastatic Prostate Cancer<\/h1>\n<p>by<strong> <a href=\"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/about\/urologists\/dr-alex-shteynshlyuger\/\">Alex Shteynshlyuger MD<\/a><\/strong><\/p>\n<hr>\n<p><strong>If you have any questions, to&nbsp;<a href=\"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/appointments\/\">schedule a consultation<\/a>&nbsp;or if you need a <a href=\"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/second-opinion\/\">second opinion<\/a>, please<a href=\"\/?page_id=876\">&nbsp;<\/a><a href=\"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/contactus\/\">contact us<\/a>&nbsp;or call: <a href=\"tel:6466635515\">646-663-5515<\/a><\/strong><\/p>\n<p><a href=\"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/about\/urologists\/dr-alex-shteynshlyuger\/\">Dr. Alex Shteynshlyuger<\/a>&nbsp;&nbsp;is a board-certified urologist in NYC who&nbsp;<b>specializes in treating&nbsp;men for&nbsp;prostate cancer.<\/b><\/p>\n<hr>\n<h1>What You Need to Know About Advanced Prostate Cancer: PSA Recurrence and Metastatic Disease<\/h1>\n<p><strong>241,000 men are diagnosed yearly with prostate cancer in the US.<\/strong> &nbsp; &nbsp;Each year more than 28,000 men develop metastatic prostate cancer and most of them die from the disease.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-1301\" src=\"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/wp-content\/uploads\/sites\/4\/2014\/04\/shutterstock_283210082-300x200.jpg\" alt=\"Prostate Cancer Treatment\" width=\"300\" height=\"200\" srcset=\"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/wp-content\/uploads\/sites\/4\/2014\/04\/shutterstock_283210082-300x200.jpg 300w, https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/wp-content\/uploads\/sites\/4\/2014\/04\/shutterstock_283210082-768x512.jpg 768w, https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/wp-content\/uploads\/sites\/4\/2014\/04\/shutterstock_283210082-800x534.jpg 800w, https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/wp-content\/uploads\/sites\/4\/2014\/04\/shutterstock_283210082.jpg 1000w, https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/wp-content\/uploads\/sites\/4\/2014\/04\/shutterstock_283210082-900x600.jpg 900w, https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/wp-content\/uploads\/sites\/4\/2014\/04\/shutterstock_283210082-370x247.jpg 370w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/>After treatment for prostate cancer with surgery or radiation, <strong>20-30% of treated men will have a PSA recurrence<\/strong>.<\/p>\n<p>A man who develops PSA recurrence after treatment will survive on average 12 years based on historical data.<\/p>\n<p>Estimated 70,000 each year have PSA recurrence after definitive treatment for prostate cancer. This means that more than 1 million men are alive with PSA recurrent prostate cancer.<\/p>\n<p>Many more have metastatic prostate cancer but officially die of other \u201cintervening\u2019 causes. I suspect the actual number is probably at least double.&nbsp; As an average man with hormone-refractory prostate cancer can live at least 18-24 months. Many men are elderly with other comorbidities.<\/p>\n<h2><strong>Choice of Treatment for Men with Metastatic Disease Depends on a Variety of Factors.<\/strong><\/h2>\n<p>Patients health status (ECOG status)<\/p>\n<ul>\n<li>The therapeutic index of the medication: Safety profile of the medication<\/li>\n<li>Contraindications<\/li>\n<li>Complexity of administration<\/li>\n<li>Adverse effects from the treatment<\/li>\n<li>The familiarity of physicians with the medication<\/li>\n<\/ul>\n<p>Median survival times reported from historical studies that range from about 6 to 10 months [Eisenberger&nbsp;<em>et al.<\/em>&nbsp;1985] but have now vastly improved in contemporary clinical trials, averaging 18\u201324 months or more.&nbsp; <strong>What does that mean?<\/strong> Well Let\u2019s take <a title=\"Zytiga (Abiraterone J&amp;J) for Treatment of Prostate Cancer (mCRPC)\" href=\"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/zytiga-abiraterone\/\">Zytiga<\/a>:<\/p>\n<p>Post-docetaxel study ECOG 0-1 (patients with good functional status): OS (overall survival) of 14 months in Zytiga group vs 10 months in the placebo group.<\/p>\n<p>Non-pretreated study ECOG 0-1 (patients with good functional&nbsp;status):&nbsp; OS (overall survival) of 35&nbsp;months in Zytiga group vs 30 months in the placebo group.<\/p>\n<p>As we move earlier in the course of the disease, the opportunity window expands, as does the duration of potential treatment.&nbsp; Next step: treatment of PSA recurrent disease \u2013 average 5-7 years before it becomes metastatic.<\/p>\n<p>New treatment options for metastatic prostate cancer that have shown a significant benefit with improved survival include <a title=\"Xtandi (enzalutamide) for Treatment of Prostate Cancer\" href=\"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/xtandi-enzalutamide\/\">Xtandi<\/a>, <a title=\"Zytiga (Abiraterone J&amp;J) for Treatment of Prostate Cancer (mCRPC)\" href=\"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/zytiga-abiraterone\/\">Zytiga<\/a>, <a href=\"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/provenge-sipuleucel\/\">Provenge, <\/a>and <a title=\"Xofigo (Radium \u2013 223) for Treatment of Prostate Cancer\" href=\"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/xofigo-radium-223\/\">Xofigo<\/a>, all of which are approved for treatment of prostate cancer.<\/p>\n<p>Newer treatment options are being investigated which include <a title=\"Galeterone for Prostate Cancer\" href=\"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/galeterone\/\">Galeterone <\/a>and a number of other agents.<\/p>\n<hr>\n<p><strong>If you have any questions, to&nbsp;<a href=\"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/appointments\/\">schedule a consultation<\/a>&nbsp;or if you need a <a href=\"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/second-opinion\/\">second opinion<\/a>, please<a href=\"\/?page_id=876\">&nbsp;<\/a><a href=\"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/contactus\/\">contact us<\/a>&nbsp;or call: <a href=\"tel:6466635515\">646-663-5515<\/a><\/strong><\/p>\n<p><strong>We see patients from all parts of New York City (Manhattan, Brooklyn, Queens, Bronx, Staten Island), Long Island, Westchester and New Jersey as well as other parts of&nbsp;the USA. We also see <a title=\"International and out-of-the-area patients\" href=\"\/?page_id=1490\" target=\"_blank\" rel=\"noopener\">international patients <\/a>from&nbsp;Canada, Japan, South America, Russia, Asia, Europe, Middle East, Africa, the Caribbean and other parts of the world.<\/strong><\/p>\n<hr>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Treatment of Advanced (PSA recurrence) and Metastatic Prostate Cancer by Alex Shteynshlyuger MD If you have any questions, to&nbsp;schedule a consultation&nbsp;or if you need a second opinion, please&nbsp;contact us&nbsp;or call: 646-663-5515 Dr. Alex Shteynshlyuger&nbsp;&nbsp;is a board-certified urologist in NYC who&nbsp;specializes in treating&nbsp;men for&nbsp;prostate cancer. What You Need to Know About Advanced Prostate Cancer: PSA Recurrence [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"open","ping_status":"open","template":"","meta":{"ngg_post_thumbnail":0,"footnotes":""},"class_list":["post-6","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Treatment of Advanced (PSA recurrence) and Metastatic Prostate Cancer in NYC and Brooklyn - Prostate Cancer Specialists in NYC<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/psa-recurrence\/\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/psa-recurrence\/\",\"url\":\"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/psa-recurrence\/\",\"name\":\"Treatment of Advanced (PSA recurrence) and Metastatic Prostate Cancer in NYC and Brooklyn - Prostate Cancer Specialists in NYC\",\"isPartOf\":{\"@id\":\"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/psa-recurrence\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/psa-recurrence\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/wp-content\/uploads\/sites\/4\/2014\/04\/shutterstock_283210082-300x200.jpg\",\"datePublished\":\"2013-12-22T23:30:11+00:00\",\"dateModified\":\"2021-03-08T18:24:59+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/psa-recurrence\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/psa-recurrence\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/psa-recurrence\/#primaryimage\",\"url\":\"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/wp-content\/uploads\/sites\/4\/2014\/04\/shutterstock_283210082.jpg\",\"contentUrl\":\"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/wp-content\/uploads\/sites\/4\/2014\/04\/shutterstock_283210082.jpg\",\"width\":1000,\"height\":667},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/psa-recurrence\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Treatment of Advanced (PSA recurrence) and Metastatic Prostate Cancer in NYC and Brooklyn\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/#website\",\"url\":\"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/\",\"name\":\"Prostate Cancer Specialists in NYC\",\"description\":\"Better Science. Better Care.\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Treatment of Advanced (PSA recurrence) and Metastatic Prostate Cancer in NYC and Brooklyn - Prostate Cancer Specialists in NYC","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/psa-recurrence\/","twitter_misc":{"Est. reading time":"3 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/psa-recurrence\/","url":"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/psa-recurrence\/","name":"Treatment of Advanced (PSA recurrence) and Metastatic Prostate Cancer in NYC and Brooklyn - Prostate Cancer Specialists in NYC","isPartOf":{"@id":"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/#website"},"primaryImageOfPage":{"@id":"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/psa-recurrence\/#primaryimage"},"image":{"@id":"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/psa-recurrence\/#primaryimage"},"thumbnailUrl":"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/wp-content\/uploads\/sites\/4\/2014\/04\/shutterstock_283210082-300x200.jpg","datePublished":"2013-12-22T23:30:11+00:00","dateModified":"2021-03-08T18:24:59+00:00","breadcrumb":{"@id":"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/psa-recurrence\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/psa-recurrence\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/psa-recurrence\/#primaryimage","url":"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/wp-content\/uploads\/sites\/4\/2014\/04\/shutterstock_283210082.jpg","contentUrl":"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/wp-content\/uploads\/sites\/4\/2014\/04\/shutterstock_283210082.jpg","width":1000,"height":667},{"@type":"BreadcrumbList","@id":"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/psa-recurrence\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/"},{"@type":"ListItem","position":2,"name":"Treatment of Advanced (PSA recurrence) and Metastatic Prostate Cancer in NYC and Brooklyn"}]},{"@type":"WebSite","@id":"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/#website","url":"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/","name":"Prostate Cancer Specialists in NYC","description":"Better Science. Better Care.","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"}]}},"amp_enabled":true,"_links":{"self":[{"href":"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/wp-json\/wp\/v2\/pages\/6","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/wp-json\/wp\/v2\/comments?post=6"}],"version-history":[{"count":13,"href":"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/wp-json\/wp\/v2\/pages\/6\/revisions"}],"predecessor-version":[{"id":1975,"href":"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/wp-json\/wp\/v2\/pages\/6\/revisions\/1975"}],"wp:attachment":[{"href":"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/wp-json\/wp\/v2\/media?parent=6"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}