Michael A. Gorin Archives

Michael A. Gorin

In My Opinion: Biomarkers for the Diagnosis of Prostate Cancer

Posted by Michael A. Gorin, MD | Dec 2020

Michael A. Gorin, MD, discusses biomarkers for diagnosing prostate cancer, including PSA, mpMRI, and serum and urine tests. He gives an overview of the history of prostate specific antigen (PSA), emphasizing that PSA screening is beneficial even as he acknowledges that PSA’s high sensitivity and low specificity result in many unnecessary biopsies. There are now many serum and urine biomarker tests that can help provide more specificity, including 4KScore, Prostate Health Index, SelectMDx, and ExoDx Prostate IntelliScore (EPI), all of which are endorsed by the NCCN Guidelines. Dr. Gorin notes that, when price is considered, SelectMDx and EPI outperform the other tests. Dr. Gorin concludes the presentation by discussing how multiparametric MRI should be used in prostate cancer diagnosis, noting that while there is little official guidance on this yet, he uses it in his own practice if a patient has a PSA ≥3 and receives an abnormal result from a serum or urine biomarker test.

Crossing the Divide from Transrectal to Transperineal Biopsy

Posted by Michael A. Gorin, MD | Jun 2020

Michael A. Gorin, MD, a urologist at Urology Associates of Cumberland, Maryland, and Director of Medical Affairs for Perineologic, discusses the benefits of transperineal prostate biopsy over transrectal biopsy. He notes that transrectal prostate biopsy leads to infections in 5-7% of patients, and argues that transperineal biopsy is the best alternative for avoiding infection. Dr. Gorin acknowledges that the use of a grid-stepper unit for performing transperineal biopsy can be uncomfortable for patients, but suggests that new technology like the PrecisionPoint™ Transperineal Access System solves many of these issues. The presentation is followed by a Q&A in which Dr. Gorin discusses the importance of new coding for transperineal biopsy and the potential of variable length needles.