Integrated Diagnostics for Risk Stratification and Active Surveillance
Sanoj Punnen, MD, discusses integrated diagnostics for risk stratification and active surveillance in prostate cancer.
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Sanoj Punnen, MD, MAS, completed his medical school at Queen’s University and urology residency at the University of Toronto in Canada. He then completed a uro-oncology fellowship and Master’s in Clinical Research at the University of California, San Francisco. He is board-certified in both urology and uro-oncology. His primary research interest is in localized prostate cancer. Specifically, his work has evaluated imaging, molecular, and genomic markers that play a role in prostate cancer diagnosis and prognosis. He is also involved in outcomes and health service research on trends in the incidence and management of prostate cancer.
Posted by Sanoj Punnen, MD, MAS | Dec 2024
Sanoj Punnen, MD, discusses integrated diagnostics for risk stratification and active surveillance in prostate cancer.
Read MorePosted by Sanoj Punnen, MD, MAS | Mar 2024
Sanoj Punnen, MD, MAS, discusses the use and benefits of integrated diagnostics for monitoring prostate cancer during Active Surveillance (AS). He begins by noting that AS is becoming a popular treatment for a wide range of low-risk prostate cancers, thanks to more granular risk-stratification methods and an increasing clinical emphasis on lowering patient burden during treatment.
Dr. Punnen then discusses lowering the frequency of serial biopsies as a means of lowering patient burden during treatment. He explores studies which indicate that MRI and Gleason scoring alone are insufficient for monitoring prostate cancer progression.
Dr. Punnen concludes with an exploration of the ongoing Miami MRI-Guided Active Selection for Treatment of Prostate Cancer (MAST) trial examining the use of MRI, 4Kscore, and Decipher scores during AS. The data thus far indicates that MRI alone is not predictive of progression, and that clinicians should consider integrating other prognostic data into their AS treatment protocols.
Read MorePosted by Sanoj Punnen, MD, MAS | Mar 2023
Sanoj Punnen, MD, MAS, discusses the complementary use of liquid biomarkers and magnetic resonance imaging (MRI) in prostate cancer diagnosis.
Read MorePosted by Sanoj Punnen, MD, MAS | Mar 2021
Sanoj Punnen, MD, MAS, Associate Professor of Clinical Urology in the University of Miami Health System, explains how multimodal detection options could improve and personalize prostate cancer diagnosis, specifically the combination of MRI and biomarkers. He reviews the pros and cons of each option, noting incidence and mortality rates. To bolster his points, Dr. Punnen summarizes data from the PRECISION trial and the PROMIS trial. He also looks at a 2018 trial studying MRI and 4Kscore® for significant prostate cancer detection and a 2021 study that developed a 4Kscore®/MRI‐based tool to assist clinicians in biopsy decision‐making and counseling of those at risk for prostate cancer. Dr. Punnen concludes by calling for further research, specifically studies comparing biomarkers head-to-head and trials focusing on PET imaging and quantitative imaging.
Read MorePosted by Sanoj Punnen, MD, MAS | Apr 2020
Sanoj Punnen, MD, MAS, Associate Professor of Clinical Urology in the University of Miami Health System, describes how recent trial based research has supported the synergistic qualities of MRI and biomarkers in the cancer detection process by reducing unnecessary biopsies by approximately 25%. He notes that more research is needed to declare an ideal procedure as well as what biomarkers are most efficient. Introducing MRI reading AI by the name Habitat Risk Scoring System, he highlights his own research which could alter how MRIs are processed and increase NPV to 92% without the use of biopsy.
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