Alan H. Bryce, MD, presented “Universal Germline Screening in Prostate Cancer: The Argument Against” virtually during the Perspectives in Urology: Point Counterpoint 2020 virtual conference in November 2020.
How to cite: Bryce, Alan H. “Universal Germline Screening in Prostate Cancer: The Argument Against.” November 2020. Accessed Dec 2024. https://dev.grandroundsinurology.com/universal-germline-screening-in-prostate-cancer-the-argument-against/
Summary
Alan H. Bryce, MD, Medical Director of the Genomic Oncology Clinic at Mayo Clinic in Scottsdale, Arizona, argues against universal germline screening in prostate cancer in a point-counterpoint debate. While he agrees that identifying germline mutations is important and can have important implications for therapy and for patients’ families, Dr. Bryce observes that very few carriers are identified through germline testing. Approximately ⅔ of carriers are identified through family history-based screening, and while germline mutations are more common in men with metastatic cancer, they are uncommon in the total prostate cancer population. This means that among low- and intermediate-risk patients, 200-300 people must be screened to find one additional carrier, and among high-risk patients, approximately 50 people must be screened to find an additional carrier. Genetic testing costs money and takes up valuable counseling time, so Dr. Bryce argues that testing all patients is not a sensible allocation of resources.
About the Perspectives in Urology: Point Counterpoint 2020 virtual conference:
Presented by Program Chair and Grand Rounds in Urology Editor-in-Chief E. David Crawford, MD, as well as Program Co-Chair Dan Theodorescu, MD, PhD, this virtual conference brought together leading experts in urology, medical oncology, and radiation oncology to discuss and debate the latest topics in genitourinary cancers, primarily prostate cancer and bladder cancer. This two-day interactive conference offered topical lectures, pro/con debates, interesting-case presentations, interactive panel discussions, and interactive audience and faculty networking. A focus on prostate cancer was given on Wednesday, November 11th, with a focus on bladder cancer given on Thursday, November 12th.
ABOUT THE AUTHOR
Dr. Bryce is the Medical Director of the Genomic Oncology Clinic at Mayo Clinic Arizona in Scottsdale, where he utilizes whole genome sequencing of tumors to identify key driver mutations. This approach allows for precise targeting of a patient’s tumor, leading to a greater chance of remission.
Dr. Bryce received a BS in Biochemistry from the University of California, Los Angeles. He then went on to receive his MD from Finch University of Health Sciences/Chicago Medical School. He completed a residency at the Mayo Graduate School of Medicine, and then received a Fellowship in Hematology/Oncology, also at the Mayo Graduate School of Medicine. He eventually served as Chief Fellow of Hematology/Medical Oncology there.
Dr. Bryce studies cancer genetics and novel therapeutics with a focus on personalized medicine. His clinical practice centers on genitourinary malignancies (prostate, kidney, bladder, and testicular cancers) and melanoma. In addition, Dr. Bryce participates in community outreach to underserved populations and has an interest in health disparities research. He also conducts Phase I clinical trials of new cancer drugs.
