Herbert Lepor, MD

Herbert Lepor, MD

Herbert Lepor, M.D. received his undergraduate degree from the University of California Los Angeles in 1975 and his doctor of medicine from The Johns Hopkins University School of Medicine in 1979.  Dr. Lepor completed his surgery and urology residency training at The Johns Hopkins Hospital.  

In 1993, Dr. Lepor was appointed Professor and Chairman of the Department of Urology, NYU School of Medicine and Professor of Pharmacology at NYU School of Medicine.  Dr Lepor is presently Urologist in Chief at NYU Langone Medical Center and the “Martin Spatz Chairman of the Department of Urology” Dr. Lepor’s primary clinical and basic research interests are related to the prostate.  

Dr. Lepor  has served on the editorial boards for four major urological journals and has authored over 350 peer reviewed articles, 50 book chapters, and 12 books related to prostate cancer, benign prostatic hyperplasia, and the pharmacology of the prostate.  He is the co-founder and editor of Reviews in Urology.  Dr. Lepor has been a visiting professor at 30 institutions.  Some of Dr. Lepor’s landmark scientific contributions have focused on the identification of the autonomic intervention regulating male sexual function, development of the nerve sparing radical prostatectomy, improving outcomes following radical retropubic prostatectomy, characterization of the prostate alpha1 adrenoceptor, and the medical and surgical management of benign prostatic hyperplasia.  

In 1995, Dr. Lepor was awarded the Gold Cystoscope Award by The American Urological Association.  Dr. Lepor is a member of the American Association of Genitourinary Surgeons, Clinical Society of the American Association of Genitourinary Surgeons, the American Surgical Association, and the Johns Hopkins University Society of Scholars.

Talks by Herbert Lepor, MD

Optimal Surveillance Algorithm Following Focal Therapy of Prostate Cancer

Optimal Surveillance Algorithm Following Focal Therapy of Prostate Cancer

Posted by | Dec 2024

In this 13-minute presentation, Herbert Lepor, MD, focuses on the development and implementation of an evidence-based surveillance algorithm following focal therapy for prostate cancer. Dr. Lepor highlights the fundamental role of longitudinal PSA testing, imaging, and biopsy in monitoring patients. Key findings from his cohort of over 500 patients include:

PSA Trends as Predictors: Longitudinal consecutive PSA rises are the strongest predictors of clinically significant recurrence.
MRI Utility: Positive MRIs are associated with a 30-40% likelihood of detecting cancer, but the overall frequency of positive MRIs remains low, justifying their use selectively.
Biopsy Strategies: The cohort’s data indicate that systematically performing biopsies on patients with negative MRIs yields low detection rates, and most findings represent low-volume or less concerning disease.

Dr. Lepor concludes that the current algorithm incorporates PSA testing, selective MRI, and biopsy based on imaging or PSA trends, reducing unnecessary procedures while maintaining effective cancer surveillance. However, further data, especially at the five-year mark, are needed to refine this approach further. This pragmatic and evolving strategy balances oncologic safety with patient quality of life.

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The Changing Landscape of Focal Therapy for Prostate Cancer

The Changing Landscape of Focal Therapy for Prostate Cancer

Posted by | Dec 2024

In this 20-minute presentation, Herbert Lepor, MD, reflects on a 40-year journey in prostate cancer management and emphasizes the evolving role of focal therapy. Having performed over 5,000 radical prostatectomies, outcomes like continence, potency, and complications are critically evaluated. Challenges such as climacturia, penile shortening, and recurrence prompt the exploration of focal therapy as a patient-centered alternative. The shift towards minimally invasive options like cryoablation reflects efforts to balance cancer control with improved quality of life.

Early studies demonstrate that focal therapy effectively ablates targeted lesions with minimal in-field recurrence. MRI is a cornerstone in lesion identification and treatment planning, ensuring precision in disease localization and minimizing overtreatment. Functional outcomes from focal therapy show marked improvements, particularly in preserving sexual function and reducing urinary symptoms. Focal therapy’s growing adoption, bolstered by robust evidence and improved techniques, positions it as a transformative approach in prostate cancer care. This evolution marks a paradigm shift, with patients increasingly opting for therapies prioritizing oncologic control and quality of life.

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