Topic: Prevention and Screening

Genetic Testing for Inherited Prostate Cancer

Leonard G. Gomella, MD, FACS, discusses the evolving role of genetic testing for inherited family risks in prostate cancer patients. He advises urologists to be attentive to recent developments in genetic testing in order to better detect cancers in individual patients and their family members.

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Prostatectomy: What is the Future?

John F. Ward, MD, FACS discusses patient selection in definitive prostate cancer treatment and avoiding over and undertreatment. He then analyzes the impact of the evolving United States Preventive Services Task Force (USPSTF) recommendations for PSA screening on prostate cancer incidence, over and undertreatment, and amount of biopsies performed in urologic practice.

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Should MRI Be Used to Monitor for AS? Pro Argument

Peter A. Pinto, MD, argues that MRI can help select prostate cancer patients for active surveillance (AS). While MRI has some limitations, with proper application, it can reduce patient and urologist anxiety, repeat biopsies, and amount of cores taken during AS. Subsequently, this will reduce morbidity, bleeding, erectile dysfunction, and infections related to biopses.

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Should MRI Be Used to Monitor for AS? Con Argument

Nelson N. Stone, MD, argues that MRI’s limitations make it insufficient for evaluating and managing prostate cancer patients under consideration for active surveillance (AS) or targeted focal therapy (TFT). Instead, urologists should consider technology like the under-development 3DBiopsy™ system, with a transperineal needle along with mapping software. This approach can detect the precise location of lesions and create a roadmap for treatment planning.

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Biomarkers for Prostate Cancer: Whom to Treat

Gerald Andriole, MD, discusses the limitations and successes in the design of the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO) and European Randomized Study of Screening for Prostate Cancer (ERSPC) trials. He also emphasizes the importance of patient selection in PSA screening and utilizing other diagnostic methods.

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