Video Archives

The Prostate Cancer Proteome

Posted by Paul Boutros, PhD, MBA | Aug 2024

Paul Boutros, PhD, MBA, gives a talk on the under-explored prostate cancer proteome. Dr. Boutros discusses proteomics by delving into five reasons why they are a useful tool. His talk focuses on these reasons and he goes into detail about each one. They include the fact that proteins are the actual function units of the central dogma, they are far more diverse than RNA, they have not been looked at in much detail yet, they are abundant in urine and they have immense dynamic range. His talk then goes on to cover what tissue proteomics look like, how the proteome relates to other things we care about such as MRI visibility and urinary proteomics. He ends the talk by going over some of the caveats and reasons that proteomics might not work. Overall proteomics are incredibly complex and few have the skills to properly analyze, but it remains a major opportunity to move forward in the field.

PSMA PET Imaging

Posted by Phillip J. Koo, MD | Aug 2024

Phillip J. Koo, MD, Division Chief of Diagnostic Imaging and Northwest Region Oncology Physician Executive of Oncology at the Banner MD Anderson Cancer Center in Phoenix, Arizona, presents a primer for urologists and oncologists on prostate-specific membrane antigen (PSMA)-positron emission tomography (PET) imaging. Dr. Koo asserts that PSMA-PET is rapidly becoming a modern-day practice. He explains that not all hotspots shown on these scans are necessarily prostate cancer; sharing research demonstrating PSMA-PET images, including normal images and other findings, that are not prostate cancer. If a practitioner is uncertain, magnetic resonance imaging (MRI) can be performed. Dr. Koo highlights solitary rib lesions, which can present a challenge to clinicians due to a high proportion of false positives on the PSMA-PET scan. He then emphasizes that what is seen on the scan is only half the story, explaining that how technicians window, fuse, and send images can affect what a practitioner sees. Dr. Koo recommends that practitioners avoid sole reliance on the fused images. Practitioners should reach out to radiologists in order to gain clinical context and the opportunity to educate and learn from those experts. He then addresses variability in standard uptake value (SUV) and cites a study on the repeatability of SUV in oncologic 18F-FDG PET, concluding that practitioners should be very careful with SUV numbers and take them in context. Dr. Koo shares a scoring system for various PSMA-PET findings and calls this a clear, standardized way for practitioners to communicate with referring physicians. Finally, Dr. Koo addresses RADAR VI and VII as well as procedure guidelines for PSMA-PET.

Assessing and Managing Metabolic Risk in Patients with Prostate Cancer

Posted by Robert H. Eckel, MD, FAHA, FACC, FNLA | Aug 2024

Robert H. Eckel, MD, FAHA, FACC, FNLA, presents a high-level overview of the assessment of metabolic risk in patients with prostate cancer. He begins with a summary of the known metabolic risks associated with Androgen Deprivation Therapy (ADT) in prostate cancer management.

Dr. Eckel then presents data on the changes in patient body composition which result from 12 weeks of ADT. He notes that while weight does not significantly change in patients being treated with ADT, he reviews the impact of changes in insulin resistance, waist circumference, and other factors which contribute to metabolic syndrome.

He concludes by examining racial disparities in those who develop metabolic syndrome after being treated with ADT for prostate cancer. He presents a short questionnaire that urologists can use to assess ongoing risk during ADT.

Integration of Histology, Genomics and Proteomics with MRI

Posted by Steven S. Raman, MD | Aug 2024

Steven S. Raman, MD, explores how histology, genomics, and proteomics with MRI revolutionize the diagnosis and treatment of prostate cancer. Histology provides critical insights into the pathological features of prostate cancer; genomics offers a deeper understanding of the genetic mutations and alterations that drive cancer progression; and proteomics sheds light on the protein expressions and interactions that occur within the tumor microenvironment. Raman asserts that each modality, while powerful on its own, gains significance when integrated with MRI prostate imaging.

He elaborates on the technological advancements and methodological innovations that facilitate this integration. Raman highlights how multi-parametric MRI (mpMRI) can be augmented with molecular data from histology, genomics, and proteomics to create a more comprehensive and nuanced diagnostic picture. Recent studies show significant improvements in the detection, characterization, and monitoring of prostate cancer, leading to more personalized and effective treatment strategies.

Why We Need Organized Screening Programs

Posted by Hendrik Van Poppel, MD | Aug 2024

Em. Prof. Hendrik Van Poppel argues for the necessity of organized screening programs for prostate cancer, underscoring the impact of early detection, which can identify the disease at an earlier, more treatable stage.

Dr. Van Poppel presents compelling evidence from studies and clinical trials demonstrating that systematic screening leads to earlier diagnoses, which correlates with better survival rates. He critiques the current state of prostate cancer screening, which is often opportunistic and inconsistent, leading to disparities in early detection and treatment outcomes.

He highlights the importance of establishing clear guidelines and protocols to optimize the efficiency and effectiveness of these programs. Dr. Van Poppel advocates for the use of advanced diagnostic tools and risk stratification methods to distinguish between clinically significant and indolent cancers. Furthermore, Dr. Van Poppel emphasizes the role of public health education and awareness campaigns in promoting the benefits of organized screening.