Editor’s Choice: Tough one this week ….. very useful discussion on insurance issues, and we also learn some intersting things about Xgeva (…. see Chat), not to mention monotherapy AR blockers (rd)

Topics Discussed

PCF Scientific Retreat review; what to do when insuracne says ‘No’; managing abiraterone side effects; bone density and hormone therapy … is Xgeva a lifetime drug?; chemo may send PSA up .. THEN down!; do T levels matter with monotherapy androgen blockers?; Phase 1 trial experience with a glucocorticoid blocker; what type of SBRT to choose for gland ablation; does switching from an LHRH antagonist to agonist casue a flare?

Chat Log

Jake Hannam (to Everyone): 4:29 PM: VERU-111

Jake Hannam (to Everyone): 4:59 PM: https://www.mymedicare.gov/claimsearchresult.aspx

Jake Hannam (to Everyone): 5:07 PM: Xgeva

Jake Hannam (to Everyone): 5:07 PM: Zometa Ancan –

rick (to Everyone): 5:10 PM: Prolia …. same as Xgeva Ancan –

rick (to Everyone): 5:12 PM: denosumab ….

Len Sierra (to Everyone): 5:16 PM: Patients need to be advised of the increased risk of bone loss and vertebral fracture when therapy is stopped. If denosumab needs to be stopped, it should be replaced by an alternative osteoporosis medication to help prevent rapid bone loss and risk of fractures (Symonds CMAJ April 2018).Oct 23, 2018

Jake Hannam (to Everyone): 5:18 PM: osteo-necrosis of the jaw (ONJ) is the real danger

John I (to Everyone): 5:19 PM: thanks for the research Len & Jake

Jim Ward (to Everyone): 5:58 PM: I’ve got a question re going to 1-month Lupron shot due to the shortage after consistently doing 3-month shots

Jim Ward (to Everyone): 6:07 PM: Thanks for the comments, guys. Sorry about my mic; don’t know what’s going on there

Ken A (to Everyone): 6:07 PM: whats your t -level Jim