WEBVTT NOTE duration: "00:01:54.261" NOTE Confidence: 0.94033307 00:00:06.559 --> 00:00:08.160 It is the most common NOTE Confidence: 0.94033307 00:00:08.160 --> 00:00:08.660 polymalignancy NOTE Confidence: 0.9818867 00:00:09.200 --> 00:00:10.960 besides skin cancer in men. NOTE Confidence: 0.9818867 00:00:10.960 --> 00:00:12.160 Prostate cancer is no different NOTE Confidence: 0.9818867 00:00:12.160 --> 00:00:13.615 than any other cancer. If NOTE Confidence: 0.9818867 00:00:13.615 --> 00:00:14.895 it's caught too late, if NOTE Confidence: 0.9818867 00:00:14.895 --> 00:00:15.635 it's metastasized, NOTE Confidence: 0.9283118 00:00:15.935 --> 00:00:17.614 it's still a lethal disease. NOTE Confidence: 0.9283118 00:00:17.614 --> 00:00:18.975 For that reason, prostate cancer NOTE Confidence: 0.9283118 00:00:18.975 --> 00:00:20.095 screening, being an advocate for NOTE Confidence: 0.9283118 00:00:20.095 --> 00:00:21.055 yourself, I think is gonna NOTE Confidence: 0.9283118 00:00:21.055 --> 00:00:22.494 be very, very important. Because NOTE Confidence: 0.9283118 00:00:22.494 --> 00:00:23.375 even at this point in NOTE Confidence: 0.9283118 00:00:23.375 --> 00:00:24.595 time from my perspective, NOTE Confidence: 0.926695 00:00:25.310 --> 00:00:26.350 the health care field, health NOTE Confidence: 0.926695 00:00:26.350 --> 00:00:27.550 care providers don't have a NOTE Confidence: 0.926695 00:00:27.550 --> 00:00:28.670 hundred percent agreement on this NOTE Confidence: 0.926695 00:00:28.670 --> 00:00:29.170 topic. NOTE Confidence: 0.9545197 00:00:32.989 --> 00:00:34.850 PSA stands for process specific NOTE Confidence: 0.9545197 00:00:34.909 --> 00:00:36.190 antigen. It's a protein that NOTE Confidence: 0.9545197 00:00:36.190 --> 00:00:38.284 the prostate makes. PSA is NOTE Confidence: 0.9545197 00:00:38.284 --> 00:00:40.225 not a prostate cancer specific NOTE Confidence: 0.9545197 00:00:40.284 --> 00:00:42.364 marker. Nevertheless, it is the NOTE Confidence: 0.9545197 00:00:42.364 --> 00:00:43.565 best test we have at NOTE Confidence: 0.9545197 00:00:43.565 --> 00:00:45.085 this point in time. I NOTE Confidence: 0.9545197 00:00:45.085 --> 00:00:46.445 recommend that all patients over NOTE Confidence: 0.9545197 00:00:46.445 --> 00:00:47.485 the age of forty be NOTE Confidence: 0.9545197 00:00:47.485 --> 00:00:48.704 tested with a PSA. NOTE Confidence: 0.9319858 00:00:49.800 --> 00:00:50.680 So for instance, if you're NOTE Confidence: 0.9319858 00:00:50.680 --> 00:00:51.479 a forty year old man NOTE Confidence: 0.9319858 00:00:51.479 --> 00:00:52.360 with a PSA less than NOTE Confidence: 0.9319858 00:00:52.360 --> 00:00:53.159 one, I would tell them, NOTE Confidence: 0.9319858 00:00:53.159 --> 00:00:54.200 hey. Your PSA probably should NOTE Confidence: 0.9319858 00:00:54.200 --> 00:00:55.480 not be checked unless something NOTE Confidence: 0.9319858 00:00:55.480 --> 00:00:57.420 else changes for next decades. NOTE Confidence: 0.8277827 00:00:58.200 --> 00:00:59.160 Aging over to I do NOTE Confidence: 0.8277827 00:00:59.160 --> 00:01:00.680 recommend yearly follow for those NOTE Confidence: 0.8277827 00:01:00.680 --> 00:01:01.180 patients. NOTE Confidence: 0.95463395 00:01:03.665 --> 00:01:05.025 You have to tailor the NOTE Confidence: 0.95463395 00:01:05.025 --> 00:01:06.305 context of discussions to the NOTE Confidence: 0.95463395 00:01:06.385 --> 00:01:07.765 what the patient's current situation NOTE Confidence: 0.95463395 00:01:07.825 --> 00:01:08.325 is. NOTE Confidence: 0.93744045 00:01:15.600 --> 00:01:16.640 So this is actually the NOTE Confidence: 0.93744045 00:01:16.640 --> 00:01:17.840 step that I recommend to NOTE Confidence: 0.93744045 00:01:17.840 --> 00:01:18.640 my patients who come in NOTE Confidence: 0.93744045 00:01:18.640 --> 00:01:19.920 with a concern for prostate NOTE Confidence: 0.93744045 00:01:19.920 --> 00:01:21.200 cancer, is to get your NOTE Confidence: 0.93744045 00:01:21.200 --> 00:01:22.959 PSA checked, but never act NOTE Confidence: 0.93744045 00:01:22.959 --> 00:01:24.319 upon just one PSA. You NOTE Confidence: 0.93744045 00:01:24.319 --> 00:01:25.760 need serum measurements. So I NOTE Confidence: 0.93744045 00:01:25.760 --> 00:01:26.880 would say at least two, NOTE Confidence: 0.93744045 00:01:27.280 --> 00:01:28.845 PSA measurements, at least two NOTE Confidence: 0.93744045 00:01:28.845 --> 00:01:29.825 weeks apart. NOTE Confidence: 0.9507927 00:01:30.204 --> 00:01:31.325 It goes up and down, NOTE Confidence: 0.9507927 00:01:31.325 --> 00:01:32.125 up and down, up and NOTE Confidence: 0.9507927 00:01:32.125 --> 00:01:32.924 down. So you need to NOTE Confidence: 0.9507927 00:01:32.924 --> 00:01:34.444 know for sure if that's NOTE Confidence: 0.9507927 00:01:34.444 --> 00:01:35.645 a a PSA level that NOTE Confidence: 0.9507927 00:01:35.645 --> 00:01:37.005 is just incidental, that somehow NOTE Confidence: 0.9507927 00:01:37.005 --> 00:01:37.725 it was just at the NOTE Confidence: 0.9507927 00:01:37.725 --> 00:01:38.685 upswing, and we don't know NOTE Confidence: 0.9507927 00:01:38.685 --> 00:01:40.365 the exact reason why. And NOTE Confidence: 0.9507927 00:01:40.365 --> 00:01:41.884 based on the baseline, then NOTE Confidence: 0.9507927 00:01:41.884 --> 00:01:42.784 I think the intensity NOTE Confidence: 0.99041444 00:01:43.340 --> 00:01:44.780 to next follow-up should be NOTE Confidence: 0.99041444 00:01:44.780 --> 00:01:46.540 tailored to that patient's PSA NOTE Confidence: 0.99041444 00:01:46.540 --> 00:01:47.040 levels.