Diagnosing Aggressive Forms of Prostate Cancer With New Imaging Tests and Biomarkers
On the seventh episode of CureTalk panel discussion on prostate cancer, Chair of the Department of Neurology, Associate Director, and Senior Vice-President for translational research at Roswell Park Cancer Institute, Dr. James Mohler, discussed national guidelines for prostate cancer treatment. Dr. Mohler who chairs the National Comprehensive Cancer Network’s prostate cancer treatment guidelines panel highlighted the latest research in diagnosis of high-risk forms of prostate cancer, and strategies to avoid unnecessary treatment for low-risk forms.
According to Dr. Mohler the NCCN guidelines have now been made much simpler and much more user friendly and so he urges all listeners to pay careful attention to the simplification in this talk.
Not being biased by the fact that his friend at Roswell Park developed the PSA test, Dr. Mohler believes that overuse of PSA leads to over detection of prostate cancer. He suggests it is most valuable when used in conjunction with prior values so that one can look at the PSA kinetics, and combine PSA kinetics with your age, health and other parameters such as your digital rectal exam, family history etc. “If your PSA is less than 1 and you are less than 50 years old, you are in a very, very good place and you probably don’t need another PSA until you turn 50 years old.” says Dr. Mohler.
In this hour-long discussion, Dr. Mohler discussed the potentially appropriate use of multiple-parametric MRI in diagnosis and active surveillance along with the multiple new genetic tests. He advises against having an MRI just after prostate biopsy because the inflammation and bleeding from the biopsy may be confused with an aggressive cancer.
In near future, Dr. Mohler wishes to see all the tests that attempt to better stratify tumors in individual patients come to a fruition so that the goal of right sizing treatment can be met and people who need treatment get it, and those who don’t need it are not unnecessarily treated.
We at CureTalks thank Dr. Mohler for his time, and all his colleagues who work with him on updating the NCCN guidelines every year.