New Prostate Cancer Screening Guidelines

And we wanna get into new guidelines that we're hearing about with prostate cancer. This is to raise awareness. So September was Prostate Cancer Awareness Month, but I feel like there's never a bad time to bring you guys up to speed on everything you need to know. So we're gonna bring in Dr. Daniel Lee, who's a urologist with Penn Medicine, Abrahamson Cancer Center. Welcome on in to Philadelphia Live. Hi, how are you doing today? Thank you so much for the invitation to speak with you all. Thank you for making time for us. This is extremely important. So new screening guidelines. I mean, let's start very broadly. What are they? So just to give you a little bit of background on myself. So I am one of the assistant professors of urologic oncology. So I really specialize in prostate cancer. Over at the University of Penn, but I also sit on the guidelines committee for a group called the National Comprehensive Cancer Network, also known as the NCCN. It's basically a group of experts where we review the latest data, the most recent studies, and we help create guidelines to be able to present to patients and also to doctors and providers to make recommendations about what you should do. Now, this is really about. Prostate cancer screening. Remember, prostate cancer is the number one cancer that we're going to find in men. So it's really important that a lot of our men find out about what we should know, when should we screen, etc. And this year marked actually a pretty important change about these guidelines. You know, we're talking about the fact that there are new guidelines, but I just want to make sure everybody understands what they are supposed to do now, who's supposed to do what, because I hear that that's a big part of what's changing as well. Who does what? Yes. So there are three big things that I would really like to review with a lot of your viewership just to make sure that you know crystal clear and, you know, do you have it down cold? Number one, most important, PSA screening, meaning screening for prostate cancer works. And basically what we found, those who had this blood test, you're able to reduce the chance that you die of prostate cancer by almost 30 to 40%. It is a pretty significant improvement. So guys, please make sure you get your prostate cancer screening done. Number one, it works. Number two is a question of when to get it done. Now, here you're posting the American Cancer Society. There are different societies and different guidelines who recommend slightly different ages in terms of when to get screening done. For example, some of the other societies such as the NCCN, American Cancer Society, American Urology Association, etc. They recommend I recommend starting the screening for all men. Somewhere between the age of 45 and 50. So if you're 45 or 50 years old, just make sure, you know, around the time that you're getting a colonoscopy, you should all be getting your prostate cancer screening done. This is where it's important. It's really important to know your family history. So if you happen to be a slightly higher or individual at slightly higher risk of finding prostate cancer. So who are those folks? Number one, a family history. If you have a family history of prostate cancer. Breast cancer, colon cancer, that identifies you as being slightly higher risk in terms of finding prostate cancer. So we want you to actually screen at an earlier age, somewhere between 40 or 45. We also know that our African-American or Black men are also at slightly higher risk. So we also want you to screen a little bit earlier, again, at 40, 45. So number two, please get screened if you're somewhere between 40 and 50 years old. Right, and know your family history, ask your aunties and uncles, whoever your family members are and know what their history is. But the third big thing is if the PSA is high. Or if the PSA blood tests start increasing over time, one of the big things that we're finding is that the use of MRIs is really important to help us identify those who might be at risk for finding cancer. It actually helps with the biopsy process and potentially helps us avoid unnecessary biopsies. So again, those three things. Adjusting the guidelines, what is that helping you all with? Why are these changes so important right now? Great question, because we really want to encourage men to know when we should get testing done and know really what the evidence is behind it, right? We really want to maximize who gets tested and make sure that everyone has a real good discussion with their doctors or primary care doctors about this. But the second reason is we want to avoid potential Over diagnoses or when we don't want to screen unnecessarily, if that makes sense, meaning we want to make sure that we're reaching the right people at just the right time so that we're maximizing the potential impact. And again, we really want to make sure that especially folks who are slightly higher risk, especially if you have a known family history, please make sure that you are getting screened. Dr. Lee, I have to ask you this because I think sometimes the reason why a lot of men don't get checked is the unknown. They don't know what's going to happen when I go into this room. The door closes. So can you just explain what screening actually looks like? So that's a very great question. Now, the screening right now really is just about using the PSA blood test as the initial step. One of the things that I think a lot of our guys, I'll be honest, and we've studied this, we know this, one of the big barriers is the fear of a rectal exam. Now, a rectal exam can give your doctor or surgeon potentially more information, so sometimes it can be helpful, but it is not something that should be done by itself, meaning screening is not done with the rectal exam by It's really the PSA blood test. Again, it can be done, but for our guys out there, again, this is something where it does not have to be done. You know, especially in the beginning, usually what we'll do, and again, all the different societies have outlined this pretty clearly. If you look at, for example, the NCCN or the American Cancer Society, we have specifically patient-centered guidelines that are available, and so you can review these. So a rectal exam is not 100% necessary anymore, meaning if that That's a big barrier for folks. You can ask them not to do it. But again, sometimes your urologist or your doctor may recommend it because it can provide some important information. So, guys, please be aware of that. And I'm glad, too, that you let us know in some cases you may have an option in the kind of language that you should use when you're talking to your doctor. I think that is very helpful, too. It makes people feel like, you know, they got a little bit of power when they go into the room. Yeah, that's right. Sorry, I didn't mean to cut you off. I just wanted to point out, too, that we know of many celebrities, politicians who have had or still have prostate cancer. Of course, former President Joe Biden is or Vice President Joe Biden is one of those folks that we're talking to you all about. Robert De Niro, Ben Stiller, I think Nelson Mandela has also come out saying that he had. prostate cancer in the past as well so you know just putting it out there it is not uncommon actually you explained in the beginning that this is one of the most common types of non-skin cancer that people end up having so again it's important that we're having the conversation. Yes, 100%. And again, we really want to get the word out there. Prostate cancer, especially when you do find it early, we have newer technologies, newer treatments available, things that were not available even five years ago to be able to help improve not just the success with cancer treatment outcomes, but also the quality of life. So we really encourage you, Please don't let those things... you know, scare you off of getting screened, the knowledge is really better. And this is something where knowing earlier is really helpful. Thank you for explaining all this. And for those of you guys who are streaming along with us, if sometimes you learn a little better by reading rather than listening in to a conversation like this one, all you got to do is go to cancer.org and the new guidelines are also printed right up there for you all. So you can check it out, see what you think. And as Dr. Lee has been telling you, when the time is right, depending on what community you belong to, make sure you go get tested. Thank you so much for joining us, Dr. Lee.