Management of advanced prostate cancer in Hong Kong: Insights from an APCCC‐Derived survey

• Published in: Asia-Pacific journal of clinical oncology Vol. 15; no. S6; pp. 8 - 13
• Main Authors: Poon, Darren Ming‐Chun, Ma, Wai‐Kit, Chan, Tim‐Wai, Ho, Franklin Kwok‐Leung, Ho, Lap‐Yin, Leung, Angus Kwong‐Chuen, Leung, Simon Yiu‐Lam, Sze, Henry Chun‐Kin, Kwong, Philip Wai‐Kay, Chan, Eddie Shu‐Yin
• Format: Journal Article
• Language: English
• Published: Australia Wiley Subscription Services, Inc 01.10.2019
• Subjects: Adenomatous polyposis coli; advanced prostate cancer; Androgen Antagonists - therapeutic use; Antineoplastic Agents - therapeutic use; availability of health services; Cancer therapies; Castration; Chemotherapy; Clinical trials; Combined Modality Therapy; Consensus; Disease Management; Hong Kong - epidemiology; Humans; Intolerance; Male; Management; Menopause; Metastases; Metastasis; metastatic castration‐resistant and hormone‐sensitive/naïve prostate cancer; Patients; Practice Guidelines as Topic - standards; Practice Patterns, Physicians' - standards; Prostate cancer; Prostatectomy; Prostatic Neoplasms - epidemiology; Prostatic Neoplasms - therapy; Radiotherapy; Surveys and Questionnaires; Toxicity; treatment costs; Urology; Hong Kong; metastatic castration-resistant and hormone-sensitive/naïve prostate cancer; treatment costs; availability of health services; advanced prostate cancer
• ISSN: 1743-7555; 1743-7563
• DOI: 10.1111/ajco.13247

Aim The 2017 Advanced Prostate Cancer Consensus Conference (APCCC) convened an international multidisciplinary panel to vote on controversial issues in the management of advanced prostate cancer (APC). We aimed to compare their conclusions with the opinions of local specialists and explore the practicability of international recommendations in the healthcare setting in Hong Kong. Methods Urologists and clinical oncologists practicing in Hong Kong were invited to complete a survey based on the original APCCC 2017 questionnaire and recently published trials in APC. A joint committee of expert key opinion leaders was convened to discuss and analyze the voting differences between local specialists and the APCCC 2017 panel. Results The respondents constituted 21% (28/132) of registered urologists and 21% (31/146) of clinical oncologists in Hong Kong. Discrepancies in three key areas were identified as being the most timely for this analysis: (a) management of metastatic hormone‐sensitive/naïve prostate cancer; (b) management of metastatic castration‐resistant prostate cancer; and (c) treatment monitoring and initiation of androgen‐deprivation therapy. Fears of toxicity and intolerance among patients and physicians (especially urologists) may be driving the relative underuse of chemotherapy in multiple APC patient groups in Hong Kong. Local patients can face long wait times and limited access to contemporary imaging modalities compared with other developed countries. Conclusion Increased collaborative efforts by urologists and clinical oncologists could ensure that patients gain wider access to the latest diagnostic, treatment and monitoring modalities for APC in Hong Kong.