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Harsha Ranganath, MD, a fellow in the Division of Hematology & Oncology at the University of Tennessee West Cancer Center, discusses treatment considerations in nonmetastatic prostate cancer.

Patients with prostate cancer are living longer, says Ranganath. As such, their quality of life and overall life expectancy have to be considered when choosing an appropriate treatment strategy, says Ranganath. Among these factors are treatment toxicity as well as financial toxicity. Starting an asymptomatic and nonmetastatic patient on treatment may eliminate their opportunity to receive it later on if their disease progresses, he adds. Determining whether a patient is eligible for active surveillance depends on their comorbidities and their overall goals of care.

The most common agents that are available to patients with nonmetastatic disease include Enzalutamide (Xtandi) and Apalutamide (Erleada). Both agents are well tolerated, adds Ranganath, with the most common adverse event being fatigue.