BackTable Urology
Ep. 206 Biochemical Recurrence: Insights from AUA/ASTRO/SUO Guidelines with Dr. Todd Morgan
Tue, 17 Dec 2024
Have you checked out the AUA/ASTRO/SUO’s recently released guidelines for salvage therapy in prostate cancer biochemical recurrence? In this episode of the BackTable Urology Podcast, guest Dr. Todd Morgan from the University of Michigan and host Dr. Aditya Bagrodia continue with part two of our series on prostate cancer biochemical recurrence management. --- This podcast is supported by: Veracyte https://www.veracyte.com/decipher --- SYNPOSIS The doctors focus on the difficulty in declaring a patient 'cured' and the implications of biochemical recurrence after treatment. Dr. Morgan highlights the importance of PSA in the postoperative setting and explores the role of the Decipher Prostate Genomic Classifier in personalizing treatment. He talks through the latest AUA/ASTRO/SUO consensus on biochemical recurrence guidelines, including the significance of early salvage therapy and the integration of advanced imaging techniques like PSMA PET scans. Further, Dr. Morgan emphasizes the role for multidisciplinary evaluation, patient counseling, and future directions of research to refine treatment options. This discussion underscores the transition from adjuvant to early salvage radiation as a standard practice and considers emerging biomarker strategies to inform treatment decisions. --- TIMESTAMPS 00:00 - Introduction 03:41 - Consensus Biochemical Recurrence Guidelines 08:56 - Evolution of Post-Prostatectomy Biochemical Recurrence Management 13:24 - Patient Counseling and Risk of Recurrence 17:42 - PSMA PET Scans 20:44 - Postoperative PSA Monitoring 28:35 - The Role of Radiation 31:56 - Hormone Therapy 39:00 - Salvage Lymphadenectomy 46:30 - Future Directions and Concluding Thoughts --- RESOURCES Veracyte https://www.veracyte.com/ Salvage Therapy for Prostate Cancer: AUA/ASTRO/SUO Guideline (2024) https://www.auanet.org/guidelines-and-quality/guidelines/salvage-therapy-for-prostate-cancer
Full Episode
This week on the Backtable Podcast.
Cure is a term that we just like all of us oncologists just really have a hard time saying because pretty much everybody with a history of cancer, of any kind of cancer, has some risk of that cancer coming back. And that risk may be really, really, really low so that we kind of in lay terms use words like cure, but
Really, we tend to rely on a little bit more technical things, which sound awkward, like no evidence of disease. And basically, if we're getting two years, three years, four years out, and no evidence of recurrence, no evidence of disease, we're feeling really, really good, really optimistic.
And often, even times after surgery, when the pathology looks really encouraging, we're feeling really optimistic. And by the way, good news, we have this test, PSA, which is... despite all of its flaws in the screening setting, is an unbelievable biomarker in the post-operative setting.
Hello, everyone, and welcome back to the Backtable podcast, your source for all things urology. You can find all previous episodes of our podcast on Apple, Spotify, and at backtable.com. Now, a quick word from our sponsor. This discussion is brought to you by VeriCyte, provider of the Decipher Prostate Genomic Classifier.
Decipher Prostate is a test for patients with localized prostate cancer that can help personalize treatment. Every patient and their prostate cancer is unique, and Decipher Prostate can provide meaningful insight into the aggressiveness of each individual patient's tumor.
Because the Decipher score is derived solely from the genomic characteristics of the tumor, it provides information not available through already known clinical and pathologic factors. Decipher high-risk patients generally benefit from earlier or intensified treatment, while Decipher low-risk patients may be ideal candidates for monitoring or less overall treatment.
Decipher Prostate is the most validated gene expression test in localized prostate cancer with level one evidence in national clinical practice guidelines and more than 70 peer reviewed publications, including more than 65,000 patients. Visit Verisight.com slash Decipher to learn more. Now back to the show.
This is Aditya Bagrodia as your host this week, and I'm very excited to introduce back to the show Todd Morgan from University of Michigan, where he heads up the urologic oncology section. Todd, how's it going today?
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