Dov Kadmon, MD, presented “Counseling Men with Favorable Intermediate Risk Disease – How to Advise, What Evidence Do You Share?” during the 28th Annual Innovations in Urologic Practice conference on September 22, 2024, in Denver, Colorado.
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How to cite: Kadmon, Dov. “Counseling Men with Favorable Intermediate Risk Disease- How to Advise, What Evidence Do You Share?.” September 22, 2024. Accessed Nov 2024 . https://grandroundsinurology.com/counseling-men-with-favorable-intermediate-risk-disease-how-to-advise-what-evidence-do-you-share/
Counseling Men with Favorable Intermediate Risk Disease – How to Advise, What Evidence Do You Share? – Summary
Dov Kadmon, MD, provides a comprehensive overview of managing favorable intermediate-risk prostate cancer, focusing on patient counseling, treatment decisions, and long-term outcomes.
In this 21-minute presentation, Dr. Kadmon begins by defining favorable intermediate-risk prostate cancer as grade group 2 (Gleason 3+4), with PSA levels under 10 and limited tumor burden based on biopsy. Patients are reassured that this type of cancer is common, typically indolent, and confined to the prostate, with a slow doubling time of three to five years, allowing a broad window for therapeutic intervention.
The discussion then shifts to treatment options, emphasizing the choice between active surveillance and curative interventions like radical prostatectomy or radiation therapy. Surgery’s side effects, including urinary incontinence and erectile dysfunction, are acknowledged. Radiation therapy, while sparing immediate surgery, carries risks of chronic toxicity.
Dr. Kadmon shares insights from the UK-based ProtecT trial, comparing active monitoring, surgery, and radiation therapy. The trial shows similar overall survival rates across treatment arms, but highlights increased rates of metastasis and disease progression in the active monitoring group. He underscores that while surveillance may be appropriate for select patients, curative treatment offers a more definitive approach, especially in younger individuals or those with a longer life expectancy.
About The 28th Annual Innovations in Urologic Practice:
Presented by co-chairs Mohit Khera, MD, MBA, MPH, and Michael Coburn, MD, FACS, the Innovations in Urologic Practice conference provides a detailed review and commentary on multiple genitourinary and urologic diseases. Among the featured oncological topics are bladder cancer and immunotherapies, as well as upper tract cancer management, prostate cancer, including state-of-the-art imaging, focal therapy, and MRI. Experts also discuss new tools and techniques for nephrectomy and treating advanced renal cell carcinoma. In terms of general urological approaches, the conference also includes pelvic reconstruction and trauma; men’s health topics like male infertility, andrology, and sexual dysfunction; OAB and voiding dysfunctions; and ways to diagnose and treat infections in the urology patient.
For further educational activities from this conference, visit our collection page.