Urologic Debate Part 2: MRI vs. Molecular Markers: Which One Should I Use? Markers Perspective

Posted by E. David Crawford, MD | Nov 2020

E. David Crawford, MD, presented “Urologic Debate Part 2: MRI vs. Molecular Markers: Which One Should I Use? Markers Perspective” virtually during the Innovations in Urologic Practice 2020 virtual conference in September 2020.

How to cite: Crawford, E. David. “Urologic Debate Part 2: MRI vs. Molecular Markers: Which One Should I Use? Markers Perspective” September 26th, 2020. Accessed Apr 2024. https://dev.grandroundsinurology.com/urologic-debate-part-2-mri-vs-molecular-markers-which-one-should-i-use-molecular-markers/

Urologic Debate Part 2: MRI vs. Molecular Markers: Which One Should I Use? Markers Perspective – Summary:

In the second part of this urologic debate (Part 1 is here), E. David Crawford, MD, Editor-in-Chief of Grand Rounds in Urology and Professor of Urology at the University of California, San Diego, argues that while MRI has a role in prostate cancer detection, PSA and other molecular marker tests should be used earlier in sequence. He notes that while many healthcare providers are unhappy with the current state of early detection for prostate cancer, this has less to do with PSA’s merits as a test for determining the relative risk of prostate cancer, and more with a lack of good guidance on how to interpret it. Dr. Crawford argues that all men with a PSA greater than 1.5 should receive further evaluation, first for evidence of benign prostatic hyperplasia, and then for prostate cancer. Other molecular markers can help determine increased risk and help doctors decide whether or not to biopsy, and marker tests like ConfirmMDx can also help if a biopsy is inconclusive. Dr. Crawford concludes by noting that MRI is best used after patients have been biopsied.

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About the Innovations in Urologic Practice 2020 virtual conference:
Presented by co-chairs Mohit Khera, MD, MBA, MPH, and Michael Coburn, MD, FACS, the Innovations in Urologic Practice conference provides a detailed review and commentary on multiple genitourinary and urologic diseases. Among the featured oncological topics are bladder cancer and immunotherapies, as well as upper tract cancer management, prostate cancer, including state-of-the-art imaging, focal therapy, and MRI. Experts also discuss new tools and techniques for nephrectomy and treating advanced renal cell carcinoma. In terms of general urological approaches, conference also include pelvic reconstruction and trauma, men’s health topics like male infertility and sexual dysfunction, and ways to diagnose and treat infections in the urology patient. Dr. Crawford presented this talk virtually at this year’s conference.

About The Author

E. David Crawford, MD

Researcher-physician E. David Crawford, MD, has devoted his career in medicine to educating the public about men's health issues and finding effective techniques and procedures to address prostate cancer, the most common malignancy affecting men in the United States.

He is currently a Professor of Urology at the University of California, San Diego, and emeritus distinguished endowed Professor of Surgery, Urology, and Radiation Oncology, and Head of the Section of Urologic Oncology at the University of Colorado Anschutz Medical Campus in Aurora, Colorado. Dr. Crawford received his medical degree from the University of Cincinnati and his postgraduate training included an internship and residency in urology at the Good Samaritan Hospital in Cincinnati. He subsequently completed a genitourinary cancer fellowship at the University of California Medical Center in Los Angeles.

Dr. Crawford is an internationally recognized expert in benign prostate hypertrophy, urologic cancers, and in particular, prostate cancer. He has conducted research in the treatment of advanced bladder cancer, metastatic adenocarcinoma of the prostate, hormone-refractory prostate cancer, and other areas of urological infections and malignancies. He has authored or coauthored over 810 scientific articles, has published seven textbooks, authored over 60 book chapters, and provided more than 2,200 educational talks for patients and physicians.

In an effort to raise public awareness about prostate health, Crawford in 1989 founded the Prostate Conditions Education Council (PCEC). The non-profit organization is comprised of a consortium of leading physicians, health educators, scientists, and men's health advocates. PCEC's advocacy for free or low-cost prostate screening has affected the lives of millions of American men. He currently chairs the PCEC.

Crawford is an active member of many national and international organizations, including the American Society of Clinical Oncology, the American Urological Association (AUA), and the American Association for the Advancement of Science. Within the AUA, he has been a member of the Committee to Study Urologic Research Funding and the prostate cancer clinical trials subcommittee. Crawford served on the board of governors, the scientific advisory board of the Southwest Oncology Group, and was chairman of the Genitourinary Cancer Committee for 27 years. This group is the largest clinical trials group in the world.

Crawford's involvement in the national prostate cancer arena has been widely recognized. He has received many honors and awards, including the CAP Cure Annual Award for Scientific Presentation in 1999 In 1997, he was presented with a 'Freddie Award" at the AMA International Health and Medical Film Competition for the program, ITV: The Cutting Edge Medical Report (Prostate Cancer: Understanding, Diagnosing, and Defeating), which Crawford hosted with special guest, retired General Norman Schwarzkopf.

Crawford again won a prestigious 'Freddie Award" 5 years ago... He is a member of Best Doctors of America and was named Healthcare Provider of the Year in the Denver Metro area by the Denver Business Journal.

He has been recognized as one of the Best Doctors of America for the past two decades and is recognized as one of the top 20 urologists in the country, for men, by Men’s Health Magazine. In 2018 he received the honor of being named the Distinguished Alumnus of the Year from the University of Cincinnati School of Medicine. In May of 2019, he received the Presidential citation from the American Urological Association recognizing for his “tireless role in genitourinary cancer research that has benefited countless urologic cancer patients.” He accepted the position of Editor in Chief of Grand Rounds in Urology in June of 2019. In 2021, he was the recipient of the Merle Stringer, M.D. annual award for excellence in medicine by the Florida State Medical Association.

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