Two Onc Docs Localized Prostate Cancer x Dr. Charles Ryan 2025 UPDATE
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Mar 18, 2025 Dr. Charles Ryan, a leading GU oncologist at Memorial Sloan Kettering, discusses the latest in localized prostate cancer. He highlights the declining PSA screening rates and their impact on diagnosis. The conversation touches on key risk factors like age and genetics, and advances in diagnostics, including genomic data. Hormone therapy's role and patient management strategies are also examined. Additionally, he addresses biochemical recurrence post-treatment and the promising results of recent trials like EMBARK, emphasizing the evolving landscape of prostate cancer care.
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When To Use PSMA PET
- Use PSMA PET for high-risk localized disease, post-therapy recurrence detection, and to assess PSMA expression in advanced disease.
- PSMA PET can change staging and enable metastasis-directed therapy.
Tailor ADT Duration And Intensify For Very High Risk
- Add ADT to radiation for intermediate/high-risk disease; durations vary from 4–18 months based on risk.
- For very high-risk patients, intensify ADT with abiraterone to improve survival.
Approach To Node-Positive Patients
- Node-positive disease at diagnosis commonly receives prostate + pelvic nodal radiation plus ADT.
- Post-op pathological node positivity often prompts observation and early salvage radiation if PSA rises.