Harrison's PodClass: Internal Medicine Cases and Board Prep

Ep 158: A 58-Year-Old with an Elevated PSA

Aug 7, 2025
A 58-year-old man's elevated PSA levels spark a deep dive into prostate cancer diagnosis and treatment. The podcast reveals the rising rates of prostate cancer alongside its surprisingly low mortality. It emphasizes the importance of shared decision-making in healthcare. Genetic risks are discussed, shedding light on screening complexities. The significance of advanced imaging in understanding PSA results is also highlighted, making for a compelling conversation on balancing detection and treatment.
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INSIGHT

Screening Must Balance Benefit And Harm

  • Prostate cancer is common but usually not lethal, so screening must balance benefits and harms.
  • Detecting clinically significant cancers matters more than finding many indolent tumors.
ANECDOTE

Family Case Prompting Concern

  • The patient is worried because his 65-year-old brother has prostate cancer and is under follow-up.
  • Family history prompted discussion of hereditary risks and screening.
INSIGHT

Family And Ancestry Change Risk

  • Family history and ancestry significantly alter prostate cancer risk.
  • Genetic factors and race (e.g., African-American men) increase incidence and aggressive disease.
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