The Use of Genomic Markers and Prostate Biopsy Decisions

Posted by E. David Crawford, MD | Jun 2019

E. David Crawford, MD, presented “The Use of Genomic Markers and Prostate Biopsy Decisions” during the 24th Annual Southwest Prostate Cancer Symposium on April 11, 2019 in Scottsdale, Arizona.

How to cite: Crawford, E. David. “The Use of Genomic Markers and Prostate Biopsy Decisions” April 11, 2019. Accessed Nov 2024. https://grandroundsinurology.com/the-use-of-genomic-markers-and-prostate-biopsy-decisions/

The Use of Genomic Markers and Prostate Biopsy Decisions- Summary:

E. David Crawford, MD, discusses the concept of disruptive technologies—developments which displace established technology or create entirely new industries—in the context of prostate cancer treatment and diagnosis. He reviews new and developing technologies transforming prostate cancer care, and discusses how they can be constructive as well as destructive.

Abstract:

In recent years, new innovations and discoveries have displaced or challenged many of the reigning technologies and techniques doctors use to diagnose and treat prostate cancer. While people often perceive progress as linear, these disruptive innovations can sometimes be more destructive than constructive. On the other hand, destructive innovations can become constructive once healthcare providers learn how to effectively use them.

For example, a breakthrough genetic marker, prostate-specific antigen (PSA), has transformed prostate cancer diagnosis. It is inexpensive, efficient, and leads to early detection.

However, PSA became destructive because of overdiagnosis leading to overtreatment. Confused messaging from urologists to family practice physicians contributed to the destructiveness of this diagnostic technique. Cohering to simple messaging regarding PSA cutoff levels could help these tests become constructive again.

Similarly, 30-year-old prostate biopsy technology is arguably destructive due to complications and disparity between biopsies performed and cancers found. However, the use of end-fire needles and 3D biopsy mapping could improve this technology.

This presentation discusses numerous other technologies that have disrupted, or may soon disrupt, the field of prostate cancer management. These include the ClariCore™ optical biopsy system, digital pathology technology, fusion imaging, multi-parametric MRI, micro-ultrasound, next-generation sequencing for infection identification, and new targeted focal therapies. As these technologies transform prostate cancer care, physicians should stay informed in order to use them constructively, rather than destructively.

About the Southwest Prostate Cancer Symposium

The Southwest Prostate Cancer Symposium (SPCS) is a multi-day conference that seeks to educate urologists, radiation oncologists, medical oncologists, and other healthcare professionals involved in the treatment of prostate cancer. The topics focus on current technical aspects of diagnosis and treatment of localized and advanced disease, particularly regarding imaging, technology, and training in the related devices. Dr. Crawford presented this lecture during the 24th SPCS in 2019. In 2020, the 25th SPCS will also offer training sessions involving imaging, scanning, and prostate cancer treatment related devices on site. Please visit this page in order to register for future SPCS meetings.

ABOUT THE AUTHOR

E. David Crawford, MD

Researcher-physician E. David Crawford, MD, Jack A. Vickers Director of Prostate Research and Professor of Urology at the University of California, San Diego, has devoted his career in medicine to educating the public about men's health issues and finding effective techniques and procedures to address prostate cancer, the most common malignancy affecting men in the United States.

About The Author

E. David Crawford, MD

Researcher-physician E. David Crawford, MD, Jack A. Vickers Director of Prostate Research and Professor of Urology at the University of California, San Diego, has devoted his career in medicine to educating the public about men's health issues and finding effective techniques and procedures to address prostate cancer, the most common malignancy affecting men in the United States. Dr. Crawford received his medical degree from the University of Cincinnati and his postgraduate training included an internship and residency in urology at the Good Samaritan Hospital in Cincinnati. He subsequently completed a genitourinary cancer fellowship at the University of California Medical Center in Los Angeles. Dr. Crawford is an internationally recognized expert in benign prostate hypertrophy, urologic cancers, and in particular, prostate cancer. He has conducted research in the treatment of advanced bladder cancer, metastatic adenocarcinoma of the prostate, hormone-refractory prostate cancer, and other areas of urological infections and malignancies. He has authored or coauthored over 810 scientific articles, has published seven textbooks, authored over 60 book chapters, and provided more than 2,200 educational talks for patients and physicians. In an effort to raise public awareness about prostate health, Crawford in 1989 founded the Prostate Conditions Education Council (PCEC). The non-profit organization is comprised of a consortium of leading physicians, health educators, scientists, and men's health advocates. PCEC's advocacy for free or low-cost prostate screening has affected the lives of millions of American men. He currently chairs the PCEC. Crawford is an active member of many national and international organizations, including the American Society of Clinical Oncology, the American Urological Association (AUA), and the American Association for the Advancement of Science. Within the AUA, he has been a member of the Committee to Study Urologic Research Funding and the prostate cancer clinical trials subcommittee. Crawford served on the board of governors, the scientific advisory board of the Southwest Oncology Group, and was chairman of the Genitourinary Cancer Committee for 27 years. This group is the largest clinical trials group in the world. Crawford's involvement in the national prostate cancer arena has been widely recognized. He has received many honors and awards, including the CAP Cure Annual Award for Scientific Presentation in 1999 In 1997, he was presented with a 'Freddie Award" at the AMA International Health and Medical Film Competition for the program, ITV: The Cutting Edge Medical Report (Prostate Cancer: Understanding, Diagnosing, and Defeating), which Crawford hosted with special guest, retired General Norman Schwarzkopf. Crawford again won a prestigious 'Freddie Award" 5 years ago... He is a member of Best Doctors of America and was named Healthcare Provider of the Year in the Denver Metro area by the Denver Business Journal. He has been recognized as one of the Best Doctors of America for the past two decades and is recognized as one of the top 20 urologists in the country, for men, by Men’s Health Magazine. In 2018 he received the honor of being named the Distinguished Alumnus of the Year from the University of Cincinnati School of Medicine. In May of 2019, he received the Presidential citation from the American Urological Association recognizing for his “tireless role in genitourinary cancer research that has benefited countless urologic cancer patients.” He accepted the position of Editor in Chief of Grand Rounds in Urology in June of 2019. In 2021, he was the recipient of the Merle Stringer, M.D. annual award for excellence in medicine by the Florida State Medical Association.

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