Early Impact of the Affordable Care Act and Medicaid Expansion on Racial and Socioeconomic Disparities in Cancer Care
Objectives: We sought to evaluate sociodemographic disparities in insurance coverage among nonelderly adults with a common cancer after Affordable Care Act (ACA) implementation. Patients and Methods: In total, 109,182 patients aged 18 to 64 years diagnosed with a common cancer (lung, breast, or prostate cancer) were identified from 2010 to 2014. Multivariable logistic regressions analyzed associations between ACA implementation and uninsured rates on the basis of state approach to Medicaid expansion, stratified by race (black, white), and income (stratified at 138% Federal Poverty Line). Results: Uninsured rates declined after ACA implementation, with the greatest rate reductions associated with traditional Medicaid expansion (Pinteraction
Purpose: The availability of novel imaging modalities (NIM) in prostate cancer (PCa) has overtaken the evidence informing their use. The recent EORTC consensus statement on modern imaging recognises the need for large-scale clinical trials of novel imaging . The UK environment is well placed to conduct such trials; the NCRI prostate cancer CSG wished to benchmark current UK imaging availability and practice to inform future national trials.
Purpose: The role of pelvic nodal irradiation in prostate cancer remains controversial. Nevertheless, many high-risk patients are treated with prostate and pelvis radiotherapy in addition to androgen deprivation therapy (ADT) . A recent retrospective study  and data from the UK Stampede control arm  suggest that radiotherapy may be of benefit to node positive patients. The aim of our study was to document outcomes in patients with node positive prostate cancer treated with pelvic nodal radiotherapy in a UK cancer centre.
Purpose: Relapsed or progressive prostate cancer frequently manifests as consecutive PSA rises long before disease is clinically detectable. Imaging with novel radiotracers targeting prostate-specific membrane antigen (PSMA) has been shown to be more sensitive in identifying the site of disease at lower PSA levels compared with conventional imaging, which may provide increased opportunity for salvage therapy, more aggressive local management of oligometastatic disease or increased confidence in proceeding with systemic therapy .
Purpose: To assess the benefits and risks of co-administering maintenance prednisolone with docetaxel and androgen-deprivation therapy (ADT) in hormone sensitive metastatic prostate cancer (HSMPC).
Purpose: As doctors we are required to take consent for radiotherapy; we typically take written consent . We must tell a patient if a treatment might result in a serious adverse outcome, even if the likelihood is very small . As many cancer centres move towards tumour site-specific consent forms for prostate radiotherapy we wanted to ascertain if there was consensus.
In this study, we describe our experience with both drugs at the Diana Princess of Wales Hospital (DPoW), Grimsby.
Purpose: The STAMPEDE trial has recently shown a benefit in overall survival by irradiating the prostate of patients with newly diagnosed metastatic prostate cancer . This benefit was only shown in patients with low burden of metastatic disease, as per the CHAARTED criteria . The current standard of care for these patients is androgen deprivation therapy ± docetaxel chemotherapy and radiotherapy to symptomatic areas of disease if required. The aim of this audit is to determine the potential number of men with low burden of metastatic disease who may require additional radiotherapy.
Purpose: Radiotherapy to the prostate in mHSPC improves overall survival and progression-free survival (PFS) for patients with low-volume disease . Radium-223 in metastatic castration resistant prostate cancer improves overall survival . We conducted a prospective phase I/II clinical trial in mHSPC, testing the combination of LHRHa with concurrent pelvic radiotherapy and radium-223.
Purpose: Prostate cancer in Black men has traditionally been associated with poorer outcomes than in their White counterparts. However, this perception has been largely extrapolated from studies in the localised cancer to the advanced cancer setting, where there have been few studies. We aim to evaluate whether ethnicity influences outcome in the advanced prostate cancer setting based on real-world data.
ABSTRACT Introduction: Use of androgen deprivation therapy (ADT) in carcinoma prostate (CaP) has deleterious effect on bone mineral density (BMD) leading to increase incidence of osteoporosis and skeletal-related events. We evaluated bone health status and impact of bone-directed therapy (BDT) and ADT on BMD in these patients from Jan 2015-Dec 2018. Materials and Method: Baseline bone health was assessed using Tc-99 MDP Bone scan/ DEXA scan for patients on ADT. Monthly zoledronic acid (ZA) was given to high-risk candidates (T-score ≤ 2.5 or previous hip/vertebral fracture) or Skel et al. metastatic patients who were rec...