Cancer Frontiers (Audio)

UCSF’s Dr. Cornelia Ding demystifies the prostate cancer pathology report and explains how to read and understand it. The report contains five key sections: patient information, diagnosis and comments, gross description, and any addendums or amendments. It serves multiple purposes—as a medical, legal, and clinical communication tool—and often contains technical language not written for patients. Dr. Ding walks through important terminology such as Gleason score, Grade Groups, and specific diagnostic patterns like intraductal carcinoma, emphasizing how each affects risk assessment and treatment planning. Patients are encouraged to focus on the diagnosis and comment sections and to discuss any unclear details with their doctors. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40797]

Dr. Samuel Washington presents an in-depth overview of prostatectomy, a surgical option for treating prostate cancer confined to the prostate gland. He explains how robotic-assisted laparoscopic surgery allows for precise removal of the prostate and seminal vesicles while minimizing recovery time and hospital stay. Washington discusses the importance of imaging, biopsy results, and patient risk levels in guiding decisions about lymph node removal and nerve-sparing techniques. He emphasizes realistic expectations around recovery, including urinary incontinence and erectile dysfunction, and outlines strategies for managing these outcomes, such as rehabilitation programs and medication. He also addresses the anatomical changes caused by surgery and the impact on fertility and sexual function. Emerging technologies aim to further improve surgical precision and cancer removal. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40802]

Prostate cancer remains the most commonly diagnosed cancer and second leading cause of cancer death among men in the U.S., with evolving screening and treatment practices reshaping care in 2025. UCSF's Dr. Matthew Cooperberg highlights a shift away from overdiagnosis and overtreatment of low-risk cancers, focusing instead on identifying aggressive disease through tools like MRI and advanced biomarker tests. A new “smarter screening” model now guides primary care, recommending long testing intervals for men with low PSA levels. While active surveillance has increased nationally, significant variation in care remains, and racial disparities—especially for Black men—persist. Patients are encouraged to take time in making treatment decisions, as prostate cancer often progresses slowly and allows for thoughtful, personalized care. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40796]

In this presentation, UCSF’s Dr. Eric Small explains the role of androgen deprivation therapy (ADT) in prostate cancer treatment across various stages of the disease. He discusses how prostate cancer cells rely on testosterone to grow and how medications can effectively reduce testosterone levels by targeting hormone signals or blocking production. Dr. Small outlines the different forms of ADT—injectables, implants, and pills—and reviews their pros, cons, and side effect profiles, including cardiovascular considerations. He also describes how combining ADT with newer androgen signaling inhibitors has improved survival outcomes in patients with metastatic or recurrent disease. The talk emphasizes the importance of balancing treatment benefits with side effects and highlights the role of shared decision-making in choosing the right approach. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40799]

Dr. Hao Nguyen presents focal therapy as a promising treatment option for carefully selected prostate cancer patients, especially those with intermediate-risk, localized disease. Unlike whole-gland treatments, focal therapy targets only the tumor while preserving healthy tissue, reducing the risk of side effects like urinary or sexual dysfunction. UCSF offers multiple approaches—high-intensity focused ultrasound, cryotherapy, and irreversible electroporation—selected based on tumor location and anatomy. Dr. Nguyen emphasizes the importance of precise imaging, MRI fusion biopsy, and genomic testing for patient selection and treatment planning. Early outcomes show encouraging results, with most patients avoiding surgery or radiation within two years and maintaining quality of life. While not yet standard first-line care, focal therapy is gaining traction through research and expert consensus. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40804]

Dr. Thomas Hope presents PSMA PET imaging as a transformative advancement in prostate cancer care. This technology uses a radioactive tracer to precisely detect cancer spread by targeting PSMA, a protein found on prostate cancer cells. It outperforms traditional bone and CT scans in sensitivity and accuracy, allowing for better staging and treatment planning. PSMA PET improves radiation therapy outcomes by revealing cancer in areas previously undetected. While multiple tracers exist, all FDA-approved options show similar performance, and accessibility is the key factor. Hope also discusses current challenges, including false positives and rare cases of PSMA-negative tumors. Ongoing research explores replacing biopsy or MRI with PSMA PET in select patients. Today, PSMA PET is considered the standard imaging method in nearly all stages of prostate cancer. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40806]

UCSF oncologist Dr. Jonathan Chou discusses how genetics and genomics are transforming the diagnosis and treatment of prostate cancer. He explains how inherited and acquired mutations—especially in DNA repair genes like BRCA2—can impact both cancer risk and treatment decisions. Dr. Chou outlines how UCSF researchers use tumor and blood-based biopsies to identify key mutations and genomic features that help tailor care for each patient. Examples include how genomic scores can predict response to radiation and how targeted therapies like PARP inhibitors benefit patients with specific mutations. The talk highlights the growing role of precision medicine in guiding individualized treatment plans based on the unique genetic profile of each patient’s cancer. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40798]

UCSF's Dr. Rahul Aggarwal explains the role of clinical trials in advancing prostate cancer treatment and how trial design is evolving to match today’s more personalized approaches. He highlights how UCSF has contributed to major prostate cancer therapies and emphasizes the importance of genetic and genomic testing in identifying suitable trials for each patient. Dr. Aggarwal explains the different trial phases, clarifies common myths—such as concerns about placebos—and stresses that trials are considered at every stage of disease. He also discusses efforts to improve access, affordability, and diversity in trial participation, including regional partnerships and digital matching tools. The talk encourages patients to be informed and proactive when considering clinical trials as part of their treatment plan. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40800]

William Lowry, Ph.D., discusses manipulating metabolic pathways in hair follicle stem cells to inhibit tumorigenesis. By blocking glycolysis and glutamine lysis simultaneously, they observed tumor regression, highlighting the complex interplay between metabolism and cancer. Series: "Stem Cell Channel" [Health and Medicine] [Science] [Show ID: 39256]

Scientists, leaders, and patients discuss the intersection of cutting-edge science and real-world impact. They explore the importance of patient perspectives in shaping medical advancements and how collaboration fuels groundbreaking research. Key scientific achievements in areas like regenerative medicine, cancer therapies, and space biology are highlighted. The group emphasizes the need for scientists to engage more with the public—through social media and media appearances—to help people understand and value the life-changing discoveries in science.

Featuring:

Catriona Jamieson, M.D., Ph.D.

UC San Diego

Sandra Dillon

Patient Advocate

Alexander Khalessi, M.D., M.B.A.

UC San Diego

Jana Stoudemire

Celestial Strategy, LLC

Alysson Muotri, Ph.D.

UC San Diego

Rebecca Moores

Philanthropist and Patient Advocate

Series: "Stem Cell Channel" [Health and Medicine] [Science] [Show ID: 40519]