E. David Crawford, MD

Editor-in-Chief, Emeritus
Grand Rounds in Urology
Jack A. Vickers Director of Prostate Research
Professor of Urology
University of California, San Diego

San Diego, California

Researcher-physician E. David Crawford, MD, has devoted his career in medicine to educating the public about men's health issues and finding effective techniques and procedures to address prostate cancer, the most common malignancy affecting men in the United States.

He is currently a Professor of Urology and Jack A. Vickers Director of Prostate Research at the University of California, San Diego. Dr. Crawford received his medical degree from the University of Cincinnati and his postgraduate training included an internship and residency in urology at the Good Samaritan Hospital in Cincinnati. He subsequently completed a genitourinary cancer fellowship at the University of California Medical Center in Los Angeles.

Dr. Crawford is an internationally recognized expert in benign prostate hypertrophy, urologic cancers, and in particular, prostate cancer. He has conducted research in the treatment of advanced bladder cancer, metastatic adenocarcinoma of the prostate, hormone-refractory prostate cancer, and other areas of urological infections and malignancies. He has authored or coauthored over 810 scientific articles, has published seven textbooks, authored over 60 book chapters, and provided more than 2,200 educational talks for patients and physicians.

In an effort to raise public awareness about prostate health, Crawford in 1989 founded the Prostate Conditions Education Council (PCEC). The non-profit organization is comprised of a consortium of leading physicians, health educators, scientists, and men's health advocates. PCEC's advocacy for free or low-cost prostate screening has affected the lives of millions of American men. He currently chairs the PCEC.

Crawford is an active member of many national and international organizations, including the American Society of Clinical Oncology, the American Urological Association (AUA), and the American Association for the Advancement of Science. Within the AUA, he has been a member of the Committee to Study Urologic Research Funding and the prostate cancer clinical trials subcommittee. Crawford served on the board of governors, the scientific advisory board of the Southwest Oncology Group, and was chairman of the Genitourinary Cancer Committee for 27 years. This group is the largest clinical trials group in the world.

Crawford's involvement in the national prostate cancer arena has been widely recognized. He has received many honors and awards, including the CAP Cure Annual Award for Scientific Presentation in 1999 In 1997, he was presented with a 'Freddie Award" at the AMA International Health and Medical Film Competition for the program, ITV: The Cutting Edge Medical Report (Prostate Cancer: Understanding, Diagnosing, and Defeating), which Crawford hosted with special guest, retired General Norman Schwarzkopf.

Crawford again won a prestigious 'Freddie Award" 5 years ago... He is a member of Best Doctors of America and was named Healthcare Provider of the Year in the Denver Metro area by the Denver Business Journal.

He has been recognized as one of the Best Doctors of America for the past two decades and is recognized as one of the top 20 urologists in the country, for men, by Men’s Health Magazine. In 2018 he received the honor of being named the Distinguished Alumnus of the Year from the University of Cincinnati School of Medicine. In May of 2019, he received the Presidential citation from the American Urological Association recognizing for his “tireless role in genitourinary cancer research that has benefited countless urologic cancer patients.” He accepted the position of Editor in Chief of Grand Rounds in Urology in June of 2019. In 2021, he was the recipient of the Merle Stringer, M.D. annual award for excellence in medicine by the Florida State Medical Association.

Disclosures:

Talks by E. David Crawford, MD

ESMO Updates – EMBARK Study & PSMAfore Trial

Posted by E. David Crawford, MD | Nov 2023

Editor-in-Chief of Grand Rounds in Urology, E. David Crawford, MD, and Stephen J. Freedland, MD, discuss highlights on prostate cancer research from the recent European Society for Medical Oncology (ESMO) meeting in Madrid, Spain. At that meeting, Dr. Freedland presented on the EMBARK trial, a Phase 3, randomized study of enzalutamide or placebo-plus-leuprolide acetate and enzalutamide monotherapy in high-risk, biochemically recurrent prostate cancer. With regard to how these treatments affect quality of life, he explains there is no evidence of a difference in quality of life among them and the major takeaway is that patients do not have to sacrifice quality of life to get cancer benefits.
Dr. Freedland then addresses the PSMAfore clinical trial of patients who had failed when treated with a non-hormonal agent, had a positive prostate-specific membrane antigen (PSMA) scan, and were eligible for PSMA lutetium therapy (Pluvicto). The patients were randomized for Pluvicto or other androgen receptor (AR)-targeted agents. The primary outcome was radiographic progression-free survival.
Dr. Freedland characterizes the study as very positive and clinically relevant with over a 57 percent delay in progression. He explains that afterward, 84 percent of patients who were receiving the other AR-targeted agents ended up crossing over to receive the Pluvicto. Dr. Freedland points out that overall survival between the trial arms showed no difference and asserts that between these results and those shown during the VISION trial, establishing Pluvicto as a tool practitioners should be using for these eligible patients.
Drs. Crawford and Freedland conclude that these are compelling research developments, and Dr. Freedland asserts that these were among the biggest take-home messages from the ESMO meeting.

GRU PET Tumor Board: Case #2

Posted by E. David Crawford, MD | Nov 2023

In this discussion, the second in a trilogy on PSMA PET supported by Blue Earth Diagnostics, three experts join E. David Crawford, MD, Editor-in-Chief at Grand Rounds in Urology, to discuss a challenging case study. Dr. Crawford introduces the case study of a 68-year-old male with rising prostate-specific antigen (PSA) levels one year after a radical prostatectomy to a panel of experts comprised of:

Phillip J. Koo, MD – Division Chief of Diagnostic Imaging and Northwest Region Oncology Physician Executive at the Banner MD Anderson Cancer Center.
Paul L. Nguyen, MD – Director for Radiation Oncology at the Dana-Farber/ Bringham and Women’s Genitourinary Clinical Center; Vice-Chair of Clinical Research in the Department of Radiation Oncology and Professor at Harvard Medical School; Baldwin-Politi Distinguished Chair in Oncology and Associate Director of the Harvard Radiation Oncology Residency Program at Brigham and Women’s Hospital in Boston, Massachusetts.
Daniel P. Petrylak, MD – Director of Genitourinary Oncology, Professor of Medicine and Urology, Co-Leader of Cancer Signaling Networks, and Co-Director of the Signal Transduction Program at Yale University Cancer Center in New Haven, Connecticut.
After reviewing the background of the case, Dr. Crawford displays the patient’s scans. The board analyzes the results of the scans and calls attention to nodes near the patient’s iliac bone and prostate bed which could indicate recurrence.

As the results of multiple tests on the patient are revealed, Dr. Petrylak, Dr. Nguyen, and Dr. Koo offer their insights into appropriate treatments for the patient. These range from treating the patient with SBRT to focal radiation therapy and ADT. When the patient’s final tests are revealed, the board decides on a course of finasteride and a 3-month follow-up.

GRU PET Tumor Board: Case #1

Posted by E. David Crawford, MD | Oct 2023

In this discussion, the first in a trilogy on PSMA PET supported by Blue Earth Diagnostics, three experts join E. David Crawford, MD, Editor-in-Chief at Grand Rounds in Urology, to discuss a challenging case study. Dr. Crawford introduces the case study of a 71-year-old pulmonologist with prostate cancer and rising prostate-specific antigen (PSA) levels to a panel of experts comprised of:

Phillip J. Koo, MD – Division Chief of Diagnostic Imaging and Northwest Region Oncology Physician Executive at the Banner MD Anderson Cancer Center in Phoenix, Arizona.

Paul L. Nguyen, MD – Director for Radiation Oncology at the Dana-Farber/ Bringham and Women’s Genitourinary Clinical Center; Vice-Chair of Clinical Research in the Department of Radiation Oncology and Professor at Harvard Medical School; Baldwin-Politi Distinguished Chair in Oncology and Associate Director of the Harvard Radiation Oncology Residency Program at Brigham and Women’s Hospital.

Daniel P. Petrylak, MD – Director of Genitourinary Oncology, Professor of Medicine and Urology, Co-Leader of Cancer Signaling Networks, and Co-Director of the Signal Transduction Program at Yale University Cancer Center.

After reviewing the case, Dr. Koo suggests taking an aggressive approach with imaging considering the patient’s rising PSA following a definitive therapy. He focuses on the role of PSMA PET imaging and its capabilities in the case study. Dr. Petrylak evaluates the patient’s PSA levels and explains the roles of androgen deprivation therapy (ADT) and radiation therapy in the patient’s treatment. Dr. Nguyen reviews the case study patient’s nadir PSA after radiation, rectal spacers, ADT, and treatment options following local recurrence after radiation. He expresses his preference for an MRI and PET imaging, adding his hesitation to proceed with focal therapy again for the patient.

Optilume® BPH Catheter System Data from the PINNACLE Trial Published in the September 2023 Journal of Urology

Posted by E. David Crawford, MD | Oct 2023

Steven A. Kaplan, MD, joins E. David Crawford, MD, Editor-in-Chief of Grand Rounds in Urology, to discuss the results of the PINNACLE trial published in the September 2023 issue of the Journal of Urology. The PINNACLE trial was a Phase 3 study examining the effectiveness of treating benign prostate hyperplasia (BPH) with the Optilume® BPH Catheter System.

The Optilume® BPH Catheter System is a novel drug/device combination minimally invasive surgical therapy for the treatment of lower urinary tract symptoms secondary to BPH, and it has been recently approved by the FDA. Dr. Kaplan explains how the mechanical dilation with Optilume® BPH achieves an anterior commissurotomy separating the lateral lobes of the prostate, while delivery of paclitaxel is intended to maintain luminal patency during healing.

Over the course of the discussion, Drs. Kaplan and Crawford examine:

The history of devices used to treat BPH.
The design of the Optilume® BPH Catheter System and its effects on flow and proliferative rates.
The design of the PINNACLE trial.
The immediate and long-term results for patients treated with Optilume® BPH versus those of patients treated with the sham.
What the results may mean for the future of BPH treatment in office and ambulatory settings.
For more informational content on the latest developments on men’s health topics like BPH, please visit our Men’s Health Next-Generation Learning Center.

The Impact of PDE5 Inhibitors on Major Adverse Cardiac Events

Posted by E. David Crawford, MD | Jul 2023

E. David Crawford sits down with Robert A. Kloner, MD, PhD, and Raymond Rosen, MD, to discuss retrospective evidence of PDE5 inhibitors in preventing major adverse cardiac events (MACE) in men. Crawford, Kloner, and Rosen discuss a retrospective study examining occurrences of MACE in men which demonstrated a significant reduction in MACE in men using PDE5 inhibitors versus those who were not.

They discuss the possibility of over-the-counter (OTC) approval for PDE5 inhibitors, but acknowledge that FDA approval for OTC use of PDE5 inhibitors is not assured. Dr. Rosen discusses the barriers faced by regulatory authorities in approving over-the-counter PDE5 inhibitors. Dr. Kloner discusses pharmacist-mediated prescriptions of PDE5 inhibitors and the patient screening involved. They conclude by touching on the use of PDE5 inhibitors for female patients, and the European OTC PDE5 inhibitor trials which are presently ongoing.

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