The Fellow on Call: The Heme/Onc Podcast Episode 084: Prostate Cancer Series: Pt. 1 - Introduction
Dec 6, 2023
Prostate cancer is a prevalent concern for men, and this discussion dives into its complexities. Screening methods and controversial PSA testing are highlighted. The podcast also covers risk stratification using Gleason scores and staging. Local treatment options—from active surveillance to surgery—are explored. Key terminologies, such as castrate-sensitive and castrate-resistant states, are defined. The hosts set the stage for upcoming conversations with experts in the field, ensuring listeners are well-informed.
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Screening Tradeoffs And Outcomes
- Prostate cancer is common but often slow-growing, so many men die with it rather than from it.
- Screening reduces prostate-cancer deaths in some trials but does not clearly improve overall survival.
Use Shared Decision-Making For PSA
- Use shared decision-making for PSA screening discussions, especially around age 50 for average-risk men.
- Refer patients with abnormal PSA to urology to assess clinical significance and need for biopsy.
Require 12-Core Biopsy Sampling
- Ensure urologists obtain a 12-core biopsy to minimize sampling error when diagnosing prostate cancer.
- Consider >50% core involvement as a marker of higher-risk disease on pathology.