Tuesday, March 28, 2023
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Adult & Geriatric Nurse Practitioner
Research Associate in Oncology and Urology
Faculty, School of Medicine
Johns Hopkins University
Baltimore, Maryland
Participation by Ms Sinibaldi does not constitute or imply endorsement by the Johns Hopkins University or the Johns Hopkins
Hospital and Health System.
Nurse Practitioner
Medical College of Wisconsin Cancer Center
Milwaukee, Wisconsin
Medscape, LLC staff have disclosed that they have no relevant financial relationships.
This activity has been peer reviewed and the reviewer has disclosed no relevant financial relationships.
This activity is intended for nurses and nurse practitioners.
The goal of this activity is to educate nursing professionals about current and emerging approaches with oral antiandrogen therapies in the management of locally advanced or metastatic prostate cancer to better recognize and differentiate adverse events (AEs) of therapies that target the androgen axis pathway.
Upon completion of this activity, participants will:
The Annenberg Center for Health Sciences at Eisenhower requires instructors, planners, managers and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest (COI) they may have as related to the content of this activity. All identified COI are thoroughly vetted and resolved according to the Annenberg Center for Health Sciences at Eisenhower policy. The Annenberg Center for Health Sciences at Eisenhower is committed to providing its learners with high quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest
Adult & Geriatric Nurse Practitioner
Research Associate in Oncology and Urology
Faculty, School of Medicine
Johns Hopkins University
Baltimore, Maryland
Participation by Ms Sinibaldi does not constitute or imply endorsement by the Johns Hopkins University or the Johns Hopkins
Hospital and Health System.
Nurse Practitioner
Medical College of Wisconsin Cancer Center
Milwaukee, Wisconsin
Medscape, LLC staff have disclosed that they have no relevant financial relationships.
This activity has been peer reviewed and the reviewer has disclosed no relevant financial relationships.
Jointly provided by the Annenberg Center for Health Sciences at Eisenhower and Medscape LLC in collaboration with Postgraduate Institute for Medicine
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CE Released: 6/24/2020
Valid for credit through: 6/24/2021
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Question 1: What are the best treatments for hot flashes?
Answer: Venlafaxine works well. If patients have issues dealing with side effects from that, or if it doesn't work, that's usually when they can switch to gabapentin, and maybe a low dose to start. The old adage of "start low and go slow" really applies to those medications for the hot flashes.[1]
Question 2: Do hormonal changes have a psychological effect on men?
Answer: Yes, testosterone is synonymous with some aspects of male identity, and when that is taken away it can be really distressing for some men. That is why it is important to set expectations at the onset of treatment, so that the patient is not surprised by these adverse effects from medications. Being referred to therapists or psychiatrists that have a specialization in oncology can be very helpful.[2]
Question 3: Darolutamide requires fewer pills to achieve the desired dose vs apalutamide. Since they're both approved around the same time, why not use darolutamide since the number of pills daily would be less, hopefully increasing patient compliance?
Answer: It is reasonable to give the patient darolutamide to get better compliance with the patient as you have less pills to take. But the other thing you have to remember is that there are no studies that say that darolutamide is better than apalutamide; both studies show efficacy. What clinicians do is look at the side effect profiles to determine the better drug for the patient. Darolutamide does not cross the BBB and has less fatigue or could have less fatigue, less cognitive dysfunction. So again, not only by taking 2 tablets vs 4 tablets, the toxicity may be better for the patient. When looking at the side effect profiles, darolutamide has generally lower toxicities overall compared to apalutamide and enzalutamide, and patients tend to tolerate darolutamide very well.[3-5]
References:
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