Doctor Sara Martínez, from the Urology Service of the University Hospital Complex of A Coruña, has highlighted that the approach to prostate cancer is undergoing a "profound transformation" towards a "more personalized" oncology, and has emphasized that the incorporation of precision medicine in uro-oncology drives a more preventive approach, capable of recognizing hereditary risks within the same family.
"In this context, genetic testing has ceased to be a complementary tool to become a central element in the evaluation and treatment of patients," stated Martínez during her presentation at the fourth edition of the CapVida Future and Leadership Forum on Prostate Cancer.
Astellas, together with Deusto Business School Health Executive Education, has organized the fourth edition of this training program, aimed at promoting the improvement of care quality and facilitating the integration of innovation into the clinical practice of the National Health System.
The meeting addressed some of the major current challenges in prostate cancer, including access to therapeutic innovation, the application of precision medicine, clinical decision-making in the face of biochemical recurrence, or the comprehensive checklist for treatment selection in patients with metastatic hormone-sensitive prostate cancer (mHSPC).
On the care level, specialists have delved into the management of biochemical recurrence, one of the most difficult scenarios in prostate cancer treatment. The advent of more sensitive imaging techniques, such as PET-PSMA, combined with new targeted therapies, is making it possible to detect relapses earlier and move towards much more individualized interventions.
"Today we have tools that allow us to better identify different risk profiles and adapt therapeutic decisions more precisely," indicated María José Ledo, from the Urology Service of the Puerta del Mar University Hospital in Cádiz.
"Furthermore, shared decision-making with the patient is increasingly relevant, especially in scenarios where different therapeutic options can have a different impact on quality of life," she added.
The speakers have highlighted the importance of evolving towards global and personalized care, which considers not only the characteristics of the tumor, but also elements such as comorbidities, frailty, quality of life, or each person's preferences.
"Today, therapeutic decision-making consists not only of treating more, but of treating better, selecting the strategy that provides the greatest clinical benefit with the least possible impact on quality of life," explained Antoni Vilaseca Cabo, from the Urology Service of the Hospital Clínic of Barcelona.
Along these lines, the specialist also values practical tools such as clinical 'checklists', which help to structure decision-making, make it more reproducible, and truly patient-centered in increasingly complex scenarios. "All of this contributes to more precise, shared, and adapted decisions for each patient," adds Vilaseca.
Rapid and equitable access to innovation
Although in recent years there has been a true therapeutic revolution in prostate cancer, with the advent of targeted treatments, precision medicine, and new diagnostic techniques that have improved the prognosis of numerous patients, one of the major challenges remains ensuring rapid and equitable access to these innovations, as explained by Estefanía Linares, from the Urology Service of the Hospital Universitario La Paz.
"The process of accessing medicines is complex and requires multiple stages: from European regulatory approval to national evaluation, funding, and finally, actual incorporation into hospitals. Sometimes, there are territorial differences or variable implementation times that can generate inequities in access," the specialist emphasizes.
Furthermore, she adds, the growing sophistication of personalized medicine requires considering not only clinical criteria, but also imaging techniques, biomarkers, system sustainability, and real-world outcome evaluation. "The great challenge for the healthcare system is to find a balance between speed of access and equitable availability, always putting the patient at the center of decision-making," she pointed out.
For her part, the general director of Astellas in Spain, Sandra Cifuentes, has highlighted the relevance of promoting training and collaboration spaces that support healthcare professionals in a constantly changing environment.
"Prostate cancer is experiencing very relevant advances both in therapeutic innovation and in precision medicine, and it is essential that this knowledge can be transferred quickly to daily clinical practice," he concluded.