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New Approaches to Localized Prostate Cancer Combat Overtreatment

Angelica Welch
Published: Wednesday, Nov 14, 2018

Dr. Mark Emberton

Mark Emberton, MD

Both the diagnosis and treatment of patients with localized prostate cancer have recently been re-evaluated in an effort to address overtreatment. According to Mark Emberton, MD, FRCS, the most important factor for diagnosis is location, as it provides information to help decide how soon to treat or whether active treatment is necessary.

, Emberton, professor of Interventional Oncology, Division of Surgery and Interventional Science, University College London, clinical director, Clinical Effectiveness Unit, Royal College of Surgeons of England, discussed updates in the diagnosis and treatment of patients with localized prostate cancer.

OncLive: How has the diagnosis of localized prostate cancer evolved over the last few decades?

Emberton: It hasn't been a good story, actually. For the last 40 years, the prostate has been unusual in that we have been [testing] men at risk of developing prostate cancer with a random needle deployment of the organ, which we don't do in organ systems in relation to cancer. I think we always knew that it is was unreliable and the diagnosis was uncertain, but I don't think we realized to what degree.

The ideal pathway would correct all of those errors. This analysis discusses the degree to which deriving locations has helped us resolve those errors. In summary, it doubles the risk of detecting clinically significant prostate cancer, which is astounding. Over the last 10 years or more, we have been missing half of the men with clinically significant disease, so it is not surprising that many of our treatments don't work. We also will mitigate the problem of overdiagnosis to a large degree.

Has a focus on multidisciplinary care helped in this communication?

There is no question that bringing in a mixed set of skills to a task results in benefit. It is quite interesting to look at my own professional relationships over the last 10 to 20 years. They have not been with other urologists, they are cross-disciplinary. My best friends are radiologists and pathologists because they are the people that I need in order to get the risk stratification right. One reason that we, as a unit, have been successful and able to research and innovate in the space is that we have had a team of superb radiologists that we work with constantly.
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