Oncology: Prostate
Daniel Barocas, MD
Vanderbilt University Medical Center
Sigrid Carlsson, PhD
Assistant Attending Epidemiologist
Memorial Sloan Kettering Cancer Center
Simpa Salami, MD, MPH
Assistant Professor of Urology
University of Michigan
John Wei, MD
Professor
University of Michigan
Course Description:Prostate cancer detection remains one of the most common and most controversial aspects of urological practice. In addition to the complexities around screening and use of PSA, the role of other biomarkers, biopsy techniques such as transperineal biopsy and MRI for targeted biopsy are evolving rapidly. This course is intended for urologists, advanced practice providers and trainees interested in using the most evidence-based methods for optimizing detection of clinically important prostate cancers, while improving patient experience and minimizing complications. The faculty were selected from the AUA Prostate Cancer Detection Guideline panel, and they will emphasize the newly published guidelines. The attendee will explore the continuing controversy of screening for prostate cancer, use of PSA, PSA adjuncts and isoforms, and other blood-, urine- and tissue-based biomarkers for prostate cancer detection. This will lead into a discussion of prostate biopsy, including concepts crucial to reducing morbidity of prostate biopsy and improving patient experience. This course reviews available data regarding biopsy indications and techniques, including a strong emphasis on transperineal prostate biopsy. Additionally, this course fully explores the imperative of having a purposeful approach to biopsy aimed at diagnosing clinically meaningful cancer while minimizing detection of clinically insignificant cancer. We also present the most current information regarding the use of image-guided biopsy techniques, such as MRI-ultrasound fusion guided biopsy. Finally, we will look toward the future of prostate cancer diagnosis, including risk-stratified testing, combination tests, and sequencing of imaging and biomarkers. Overall, the course provides an evidence-based and practical overview of methods to detect and diagnose prostate cancer.
Format
The format of this course will be both didactic and case based, and is designed to convey the AUA Guidelines on Prostate Cancer Detection. A panel of experts will present on topics in prostate cancer detection—use of biomarkers, use of MRI and prostate biopsy techniques, focused on transperineal biopsy. In addition, we will present common case scenarios to work through with audience participation in order to illustrate the most important, evidence-based, patient-centered methods of prostate cancer detection. We believe that this combination of techniques will enhance engagement and enable attendees to apply the evidence in practical ways within their own practices.
What is the problem we want to fix? What are the practice-based issues that you want to address?
The practice-based issue that we want to address is maximizing the benefit and minimizing the risk of prostate cancer detection. We aim to teach attendees when and how to use available biomarkers, imaging and biopsy techniques to maximize the detection of higher-grade cancers at a treatable stage, while at the same time avoiding the pitfalls of overdiagnosis and biopsy-related complications. A related problem is the ever-increasing number of tests available to aid in detection of clinically significant prostate cancer—which should be used? When? In what order? In what combination? We aim to provide attendees with the latest evidence to guide the selection, sequencing and combinations of tests to improve detection of clinically significant cancers while minimizing unnecessary tests and biopsies.