Cancer Frontiers (Video)

UCSF experts present four major approaches to managing prostate cancer, each tailored to disease risk and patient needs. Dr. Peter Carroll explains how active surveillance uses MRI, PSA, and genomic testing to safely delay treatment in low-risk cases while preserving quality of life. Dr. Samuel Washington details prostatectomy, highlighting robotic-assisted surgery’s precision and its impact on recovery, fertility, and sexual function. Dr. Julian Hong outlines radiation therapy options like SBRT and brachytherapy, emphasizing targeted delivery to limit side effects and the importance of ongoing follow-up. Dr. Hao Nguyen introduces focal therapy, which treats only the tumor using techniques like cryotherapy or high-intensity ultrasound, helping patients avoid surgery or radiation while maintaining function and quality of life. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40866]

Amanda Lewis, Ph.D. investigates how glycan-degrading enzymes contribute to bacterial vaginosis (BV), a common condition linked to infertility, preterm birth, pelvic inflammatory disease, and increased cancer risk. Her research shows that BV-associated bacteria strip protective sugar coatings—glycans—from vaginal epithelial cells, disrupting normal function and increasing vulnerability to infection. Lewis and her team study specific enzymes, such as sialidases, that remove sialic acid from glycoproteins and mucins. Using clinical samples and imaging techniques, they identify how these changes in glycan composition correlate with disease severity. Their work reveals how glycan degradation contributes to persistent or recurrent BV and opens new pathways for understanding the microbiome's role in women’s health. Series: "Motherhood Channel" [Health and Medicine] [Show ID: 40678]

Immunotherapy expert Dr. David Oh explains how the immune system can be trained to recognize and fight prostate cancer. He outlines key immune players—dendritic cells and T cells—and describes how immunotherapies target different stages of their interaction with tumors. Oh highlights FDA-approved treatments such as Provenge, a vaccine made from a patient’s own cells, and PD-1 checkpoint inhibitors for patients with specific genetic mutations like microsatellite instability. He also discusses potential autoimmune side effects and emphasizes the importance of genetic testing. Looking ahead, he introduces bispecific T-cell engagers, experimental therapies that physically link T cells to tumors, triggering an immune attack. These promising treatments offer new hope, especially for men with advanced, treatment-resistant prostate cancer. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40811]

Radiation oncologist Dr. Julian Hong explains how radiation therapy works and its central role in treating prostate cancer, both when the disease is localized and when it has spread to limited areas. He outlines major radiation options, including external beam radiation, stereotactic body radiation therapy (SBRT), and brachytherapy, and describes how treatment plans are carefully tailored using imaging, planning scans, and computer modeling to maximize precision and minimize side effects. Hong highlights advances in targeting and beam modulation, which allow for safer, more effective treatment. He also discusses typical timelines for treatment, short- and long-term side effects, and the importance of ongoing follow-up to manage late effects of therapy. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40803]

Dr. Ivan de Kouchkovsky explains how radioligand therapy delivers targeted radiation to prostate cancer cells using a radioactive isotope attached to a molecule that binds to PSMA, a protein commonly expressed in these tumors. He reviews key clinical trials showing how the therapy improves survival and quality of life for men with metastatic castration-resistant prostate cancer, both after and before chemotherapy. The FDA now approves this approach for patients who have progressed on hormone therapy, even if they haven’t yet received chemotherapy. De Kouchkovsky also highlights efforts to enhance effectiveness by combining therapies, increasing radiation dose, and targeting resistant or PSMA-negative cells. Diagnostic imaging plays a critical role in selecting patients most likely to benefit from treatment. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40810]

UCSF researchers June Chan and Stacey Kenfield share evidence-based strategies for improving prostate cancer outcomes through exercise and diet. They highlight studies showing that physical activity—including resistance and high-intensity interval training—is linked to lower risk of prostate cancer progression and death. They discuss plant-based diets, dietary indices, and specific foods like tomatoes, fish, and nuts, along with the benefits of substituting plant oils for butter. Their analysis includes findings on racial disparities and underscores the need for inclusive research. They also describe current clinical trials exploring lifestyle tools and offer guidance on navigating diet and exercise choices during cancer survivorship. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40808]

Dr. Michael Rabow, a palliative care physician, explores the wide-ranging side effects of androgen deprivation therapy (ADT) for prostate cancer and emphasizes strategies to reduce harm while improving quality of life. He outlines cardiovascular, hormonal, and emotional risks—including heart disease, osteoporosis, depression, and loss of vitality—and explains how early assessment and monitoring can help manage these effects. Dr. Rabow highlights evidence-based interventions such as physical activity and cognitive behavioral therapy (CBT), both of which improve symptoms like fatigue, sexual dysfunction, and emotional distress. He also reviews pharmacological options and stresses the importance of personalized, team-based care and shared decision-making over time. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40815]

Dr. Steven Seyedin presents an overview of PSA recurrence and risk factors for assessment. A PSA test is a blood test used to detect prostate-specific antigen (PSA) levels in the blood, which can be elevated in cases of prostate cancer and is a common screening tool. He explains how PET, CT, and MRI work, highlighting the precision of PSA PET in detecting cancer spread by targeting PSA proteins on tumor cells. This imaging method combines PET and CT to reveal metastatic disease with greater accuracy than traditional scans. Seyedin addresses the strengths of different imaging agents, emphasizing that access, not brand, is key. He also cautions against false positives, especially in bone lesions, which can mislead diagnosis. By improving staging accuracy, PSA PET supports better treatment planning and outcomes. Ongoing studies explore its use earlier in diagnosis, potentially replacing biopsy or MRI in select cases. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40805]

Prostate cancer and its treatments can significantly impact bone health, increasing the risk of fractures and weakening the immune system. Dr. Terence Friedlander explains how hormone therapy, radiation, and chemotherapy contribute to bone loss and highlights the importance of regular monitoring. He reviews the role of bone-building cells and the effects of osteopenia and osteoporosis, conditions that become more common with age and can be worsened by cancer therapies. Friedlander outlines tools like the Dexa scan and FRAX calculator to assess bone density and fracture risk, and discusses prevention strategies, including adequate calcium and vitamin D intake, weight-bearing exercise, and the use of medications like bisphosphonates and denosumab. He emphasizes proactive bone care for men with prostate cancer to help reduce complications and improve outcomes. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40812]

Dr. Kelly Fitzgerald explains current standards of care for metastatic hormone-sensitive prostate cancer, focusing on treatment strategies shaped by both clinical trial data and emerging imaging technologies. She defines key terms such as poly- and oligometastatic disease and outlines how newer imaging methods like PSMA PET scans are reshaping diagnosis. She describes the shift from traditional androgen deprivation therapy (ADT) to intensified ADT, where additional agents—such as chemotherapy or novel hormone therapies—are shown to improve survival. Fitzgerald also reviews ongoing questions around triplet therapy and the potential benefits of local treatments like radiation. She highlights the importance of patient-specific factors and the evolving definitions that influence treatment decisions in this complex disease landscape. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40809]