Active Surveillance for #ProstateCancer in 2023 | Matthew Cooperberg, MD

Donate to PCRI: https://pcri.org/donate For more information, visit www.pcri.org 5:17 The Number of people on Active Surveillance is increasing? 5:37 Proper to diagnose someone with an insignificant tumor? 5:53 Do I have "cancer"? 6:28 What is cancer? 8:05 PSA is the best screening biomarker in the history of oncology if used well 8:22 Newer screening practices 9:33 Does this mean Grade Group 1, 3+3, Dr. Cooperberg says not cancer? 10:34 GG1 is not a normal finding, but A.S. is recommended 11:58 Continuum of Biology 12:57 Arbitrary line drawn for cancer 13:45 What if we don't call it cancer? 14:49 Why the largest PSA screening trial failed 19:25 Should men go for PSA screening? 20:57 Median PSA is 0.7 between 45 and 50 21:22 If it's under 1.0, you're done 22:30 PSA values vary 23:23 What does act on PSA mean? 24:50 Liquid tests 25:54 Why not have everyone get an MRI? 26:23 What inter-observer variability exists with MRI's? 32:27 Cooperberg screening policy 33:59 DRE (Digital Rectal Exam) 40:26 How should a man choose his localized treatment? 43:15 Is there an age limit for Active Surveillance? 45:45 Mental health considerations 49:31 Confirmatory biopsy 52:01 Why can't everyone diagnosed get a BRCA/Genetic test? 56:10 What do we do differently now we know you have a BRCA mutation? 1:00:25 What about Pathology? 1:01:10 Sub-types of Pattern 4 1:02:38 Cribriform patterns 1:04:14 All GS 3+4 is not created equal 1:05:25 Is PSA density of 0.15 a valid cutoff for Active Surveillance? 1:05:50 Intraductal/large cribriform patterns for Active Surveillance? 1:06:54 Cancer is driven by the worst corner of it 1:08:06 Most Gleason 7's sent for genomic test 1:08:34 Intraductal worst pattern followed by cribriform 1:09:24 DRE's for Active Surveillance? 1:09:48 How often for PSA's/MRI's? 1:10:26 Active Surveillance 2023 (one opinion) 1:12:59 How do you choose your urologist? 1:15:00 Do PSA kinetics matter? 1:16:05 MEAL trial 1:18:22 What about exercise? 1:19:35 What about testosterone replacement therapy? 1:21:32 What about the two types of PSA tests? Don't know your stage? Take the quiz: visit http://www.prostatecancerstaging.org To learn more about prostate cancer, visit http://www.pcri.org Sign up for our newsletter here to receive the latest updates on prostate cancer and the PCRI: https://pcri.org/join Who we are: The Prostate Cancer Research Institute (PCRI) is a 501(c)(3) not-for-profit organization that is dedicated to helping you research your treatment options. We understand that you have many questions, and we can help you find the answers that are specific to your case. All of our resources are designed by a multidisciplinary team of advocates and expert physicians for patients. We believe that by educating yourself about the disease, you will have more productive interactions with your medical professionals and receive better-individualized care. Feel free to explore our website at pcri.org or contact our free helpline with any questions that you have at pcri.org/helpline. Our Federal Tax ID # is 95-4617875 and qualifies for maximum charitable gift deductions by individual donors.