GRU PET Tumor Board: Case #1
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.
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