The Fellow on Call: The Heme/Onc Podcast Episode 084: Prostate Cancer Series: Pt. 1 - Introduction
Dec 6, 2023
Prostate cancer is a prevalent concern for men, and this discussion dives into its complexities. Screening methods and controversial PSA testing are highlighted. The podcast also covers risk stratification using Gleason scores and staging. Local treatment options—from active surveillance to surgery—are explored. Key terminologies, such as castrate-sensitive and castrate-resistant states, are defined. The hosts set the stage for upcoming conversations with experts in the field, ensuring listeners are well-informed.
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Carefully Review Pathology Details
- Review pathology for core count, composite Gleason, percent cores involved, and histologic features like cribriform or intraductal patterns.
- Re-biopsy if cores are fragmented to avoid overestimating disease burden.
DRE Versus MRI For Clinical Staging
- Clinical T staging from DRE is simple: non-palpable tumors are T1 and palpable tumors are T2.
- MRI increasingly supplements DRE to better define intraprostatic extent and extracapsular spread.
Prostate TNM Includes PSA And Grade
- Prostate TNM uniquely incorporates PSA and grade into staging, and nodal involvement upstages to stage IVa.
- Distant metastases (including distant nodes) are classified as stage IVb.