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CME: Addressing skeletal-related events in prostate cancer

Activity Description / Statement of Need:

In this online, self-learning activity:

Each year, an estimated 170,000 cases of prostate cancer are diagnosed. Although early prostate cancer may be cured with surgery or radiation therapy, more than 50% of men will experience recurrence after definitive treatment. The use of androgen deprivation therapy (ADT) for intermediate-risk, high-risk, and recurrent prostate cancer has greatly increased in the last 15 years, extending 10-year survival by nearly 25% compared with observation alone. New treatment options for advanced prostate cancer have further improved survival and increased the number of patients living with non-metastatic and metastatic castration-resistant prostate cancer (nmCRPC and mCRPC). Despite the established improvements in survival associated with hormonal treatments, ADT has been associated with well-characterized negative effects on bone health. Indeed, bone metastases and subsequent skeletal-related events (SREs) are the primary driver of both morbidity and mortality among people with CRPC. In a study of 2234 men aged 65 years or older with a diagnosis of CRPC, 40% experienced SREs over a median follow-up of 10.6 months. Maintaining bone health in patients with CRPC requires routine monitoring and proactive management.

Target Audience:

The following healthcare professionals: urologists, medical and radiation oncologists, primary care physicians, nuclear medicine specialists and radiologists, and endocrinologists; physician assistants, nurse practitioners, and pharmacists who treat prostate cancer; and any other healthcare professionals who commonly care for patients with prostate cancer.


Commercial Support Disclosure: This program is supported by educational grants from AMGEN.

This activity is free of charge.

Release Date: July 31, 2020 -- Expiration Date: July 31, 2022

Faculty: Yung Lyou, MD, PhD


Faculty introduction, disclosures

Introduction content: cursory refresher and review of prostate cancer

·       Epidemiology

·       Prostate cancer disease states

·       Castration-resistant vs castration-sensitive

·       Metastatic vs non-metastatic

·       Early vs advanced disease

·       Bone health and complications

·       Androgen-deprivation therapy

·       Pain, quality of life, and morbidity/mortality

·       Recent data supporting early identification of metastases (oligometastatic disease)

·       Challenges associated with bone complications

Bone screening and monitoring in prostate cancer

·       Conventional imaging

·       New and emerging imaging modalities

Treatment options

·       Identification, assessment, and management of disease and intervention adverse effects on patients

·       Clinical trial outcomes

·       Survival

·       Time to SREs

·       Time to metastasis

·       Pain and patient-reported outcomes

·       A review of bone-targeted pharmacotherapy

·       Bisphosphonates

·       Denosumab

·       Radium-223

Summary, conclusions, and best practice recap

Learning Objectives

By the end of the session the participant will be able to:

  • Recall the relative efficacy and safety of presently available agents used to for bone health and fracture prevention in patients with prostate cancer
  • Describe the identification and management of disease and intervention adverse effects on patients
  • Using details in a patient case, recommend an appropriate pharmacotherapeutic treatment plan for the purpose of preventing SREs in patients with prostate cancer


ACCME Activity #201540541

This activity has been planned and implemented in accordance with the accreditation standards and policies of the Accreditation Council for Continuing Medical Education through ScientiaCME. ScientiaCME is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation: ScientiaCME designates this educational activity for a maximum of 0.75 AMA PRA Category 1 Credit(s)™ toward the AMA Physician's Recognition Award. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Physicians: For applicable courses, to attain maintenance of certification (MOC) credit, you must enter your board certification ID # and birth date correctly.  It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive MOC credit for this activity. Please note: not all activities on this site provide MOC credit. If this activity does not specify that it provides MOC credit in the "Accreditation" section on this page, then it does NOT provide MOC credit.


ScientiaCME is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 0.75 contact hours (0.075 CEUs) of continuing pharmacy education credit. Proof of participation will be posted to your NABP CPE profile within 4 to 6 weeks to participants who have successfully completed the post-test.   Participants must participate in the entire presentation and complete the course evaluation to receive continuing pharmacy education credit.  ACPE # 0574-0000-20-037-H01-P. ACPE Accreditation effective 7/31/2020, expires 7/31/2022. This is a Knowledge (K)-type activity.

Pharmacists: You must enter your NABP # and birth date correctly so that proof of participation can be posted to your NABP CPE profile. It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive CPE credit for this activity.

Nurse Practitioners (NPs): The American Academy of Nurse Practitioners accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.  ScientiaCME will provide NPs who successfully complete each activity with a certificate of participation indicating that the activity was designated for AMA PRA Category 1 Credit(s)™.

Physician Assistants: The American Academy of Physician Assistants accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.

Faculty Disclosure and Resolution of COI

As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review ScientiaCME.

Faculty Disclosure: Dr. Yung Lyou, MD, PhD, City of Hope Comprehensive Cancer Center,
has no relevant financial disclosures.

Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP, President of ScientiaCME, has no relevant financial disclosures.

Commercial Support Disclosure: This program is supported by educational grants from AMGEN


  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowedge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Minimum participation threshold: Take the post-test. A score of 70% or higher is required to pass and proceed to the activity evaluation.
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural and Linguistic Competence

System Requirements

Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version

Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.

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Metastatic Colon Cancer: Updates from the 2020 ASCO (American Society of Clinical Oncology) Annual Meeting