As we honor Prostate Cancer Awareness Month in September, what message do you want to send to our patients, families, and the community?
Prostate cancer has been a major public health problem in the United States, and it accounts for one of the most common cancer causes of death. Moreover, treatment of prostate cancer has been associated with a host of problems for men, including incontinence and impotence. Fortunately, in recent years, we have made enormous strides in the diagnosis, staging, and management of prostate cancer. Improvements in medical imaging (such as MRI, PET/CT, and ultrasound) have facilitated many of these advances.
How do you collaborate with your colleagues at Yale Cancer Center to care for patients with this disease?
As a radiologist at Yale, I work closely with my colleagues in urology, oncology, and pathology in caring for our patients with, or suspected of having, prostate cancer. This close collaboration has allowed us optimize care. It has also enabled us to work closely with our research scientists to develop and implement cutting-edge techniques for diagnosis and treatment of prostate cancer.
What are the most effective methods to improve outcomes for patients with prostate cancer?
One of the biggest changes in the realm of prostate cancer care in the past decade has been the dramatic increase in the use of MRI to help determine if and where an aggressive prostate cancer may reside in the prostate. If a suspicious finding is detected on the MRI scan by the radiologist, the imaging data can be electronically fused with ultrasound images and used to target a biopsy. Another major advance has been in the use of PSMA (prostate-specific membrane antigen) PET scans for the detection of hepatic metastases. These have led to fewer missed prostate cancer and metastases as well as less uncertainty about the need for a biopsy and significance of the biopsy results in individual patients. All of these cutting-edge techniques have been pioneered at Yale.
How do you envision treatment for prostate cancer will advance in the next 10 to 20 years?
I anticipate that we will continue to make advances in the non-invasive diagnosis of prostate cancer with imaging and blood tests. Importantly, we will get better at distinguishing which men have prostate cancers that can potentially harm and even kill patients, and which men have prostate cancers that are very unlikely to harm them and do not require treatment. I also anticipate that traditional surgery for prostate cancer will continue to diminish as minimally invasive image-guided treatments continue to evolve and become more refined. I am hopeful that within the next decade or so, prostate cancer will become much less of a threat to American men.