Harrison's PodClass: Internal Medicine Cases and Board Prep Ep 158: A 58-Year-Old with an Elevated PSA
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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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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.
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.
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.