Health Services Research

PV 03 - Poster Viewing Q&A - Session 3

TU_6_3013 - Prostate Cancer in an Incarcerated Population: Patient Characteristics and Treatment

Tuesday, September 17
1:00 PM - 2:15 PM
Location: ASTRO Innovation Hub

Prostate Cancer in an Incarcerated Population: Patient Characteristics and Treatment
R. R. Allison; Medical Director, Radiation Oncology, Federal Cancer Center, FMC, Butner, NC

Purpose/Objective(s): Incarcerated inmates within the Federal Correctional system who are newly diagnosed with cancer are generally transferred to the Cancer Center within the Federal Medical Center Hospital (FMC) in Butner , North Carolina. At the FMC, full time, in house, board certified oncologists offer treatment consistent with the community standard of care. This study looked at the characteristics and oncologic treatment of men transferred to FMC due to the diagnosis of prostate cancer.

Materials/Methods: This was a retrospective chart review. All men with histologically confirmed and newly diagnosed prostate cancer admitted to the FMC during the period of Jan 1 , 2018-Jan 1, 2019 were analyzed. Patients were transferred from within the continental United States and Hawaii. A total of 82 men were transferred: Age range: (36-78 years, mean 59 yrs) with 30% white, 50% African American, and 20% Hispanic.

Results: Diagnosis was most commonly due to LUTs syndrome, noted in 85% of men. Two men were diagnosed based on development of symptomatic bone mets. PSA levels for non-metastatic prostate ca at diagnosis ranged from ( 3-158 , mean 14.1 ng/ml ). Gleason score of 9 (n=7), 8 (n=9), 7 (n=37) or 6 (n=27) were noted. A total of 89% of curative patients had high grade/high volume disease and/or PSA greater than 10 ng/ml. Biopsy was by an ultrasound guided trans- rectal approach. Bone scan and pelvic CT were routinely obtained in all patients with Gleason 7 disease or higher. Genomic testing was rarely done. A total of 5 patients requested a watch and wait approach, 3 surgery and the remainder underwent external beam radiation therapy. XRT was delivered by an IMRT approach in all cases ,with all patients achieving 75.6 Gy in 42 equivalent fractions. Lupron was prescribed in 71 curative cases for 6 or 18 months depending on stage of disease.

Conclusion: Federal Inmates diagnosed with prostate cancer appear to have higher Gleason Scores , PSA levels and volumes of disease then what may be currently expected in the general population. As no prostate screening system is in place ,these more advanced malignancies likely represent the natural history of an unscreened population, which also appears to be the trend in the general population. All incarcerated patients in this study have been treated as per national guidelines. Radiation Therapy is the treatment most commonly taken, generally in combination with androgen blockade due to the higher PSA, grade and advanced disease noted.

Author Disclosure: R.R. Allison: Independent Contractor; MMG.

Ron Allison, MD, FASTRO

Naph Care

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