Two Onc Docs Localized Prostate Cancer x Dr. Charles Ryan 2025 UPDATE
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Mar 18, 2025 Dr. Charles Ryan, a leading GU oncologist at Memorial Sloan Kettering, discusses the latest in localized prostate cancer. He highlights the declining PSA screening rates and their impact on diagnosis. The conversation touches on key risk factors like age and genetics, and advances in diagnostics, including genomic data. Hormone therapy's role and patient management strategies are also examined. Additionally, he addresses biochemical recurrence post-treatment and the promising results of recent trials like EMBARK, emphasizing the evolving landscape of prostate cancer care.
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PSA Drives Most Diagnoses
- Most prostate cancers are diagnosed from an elevated PSA and are asymptomatic at detection.
- Only about 5–10% present with metastatic disease, a rate affected by PSA screening trends.
Key Risk Factors Beyond Age
- Age, BRCA2 mutations, and African ancestry increase prostate cancer risk.
- Environment exposures like Agent Orange and 9/11 exposure are niche but notable risk factors.
Gleason, Grade Group, PSA, And T-Stage
- Staging relies on Gleason/grade group, PSA, and T-stage to guide treatment.
- Grade group refines Gleason 7 into 3+4 versus 4+3 because outcomes differ.