Stacy Loeb, MD, assistant professor of Urology and Population Health at NYU Langone Health's Perlmutter Cancer Center, discusses the impact of different genomic tests for patients with prostate cancer.

Patients now have more testing options than before, states Loeb. Patients no longer need to rely on a single biopsy, as there are multiple tests which will help physicians determine the most beneficial treatment and management options for the patient.

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Stacy Loeb, MD, assistant professor of Urology and Population Health at New York University, discusses the impact of different genomic tests for patients with prostate cancer.

Dr. Loeb on the Impact of Additional Testing for Prostate Cancer

Stacy Loeb, MD, assistant professor of urology and population health at NYU Langone School of Medicine, discusses the results and impact of active surveillance on patients with prostate cancer.

Of the patients who could be considered candidates for active surveillance, one-fifth of those patients had higher Decipher scores, indicating a greater risk of aggressive disease, states Loeb. However, there were patients with intermediate-risk disease who had low Decipher scores.

Now that there are more testing options, patients do not have to rely on one biopsy test, explains Loeb. There are imaging and genomic tests that can give a patient more data and help determine if they are candidates for active surveillance.

Dr. Loeb on the Results of Active Surveillance for Prostate Cancer

Stacy Loeb, MD, assistant professor of Urology and Population Health at New York University, discusses how to determine which test will be beneficial for the management of prostate cancer.

According to Loeb, since there are many tests available now, determining which test will be most beneficial to the patient is an unanswered question. Determining which test will provide helpful and actionable information while being the most cost effective is an area that will need further research.

Dr. Loeb on Determining Beneficial Test Options for Prostate Cancer

Stacy Loeb, MD, assistant professor of Urology and Population Health at New York University, discusses test options to determine the management of patients newly diagnosed with prostate cancer.

According to Loeb, there are many tests on the market for patients with newly diagnosed prostate cancer. Oncotype DX gives the risk of finding adverse pathology if the patient had a prostatectomy. The Prolaris test gives the risk of dying from prostate cancer in 10 years without any treatment. The Decipher test investigates the patient’s chance of having high-grade disease, metastasis, or prostate cancer death.

All these options are available to patients, explains Loeb. The patient is able to decide which test result will be most beneficial to them.

Dr. Loeb on Tests for the Management of Prostate Cancer

Stacy Loeb, MD, assistant professor of Urology and Population Health at New York University, discusses active surveillance for patients with low-risk prostate cancer.

Active surveillance is a growing management option for patients with low-risk prostate cancer, states Loeb.

One of the concerns is that the risk classification for patients with prostate cancer is not completely accurate, explains Loeb. Genomic tests are being studied to confirm that patients are categorized appropriately.

Dr. Loeb on Active Surveillance for Prostate Cancer

Stacy Loeb, MD, assistant professor of urology and population health at New York University (NYU) Langone Medical Center, discusses screening determinations for prostate cancer.

It is important that patients receive a baseline measurement of PSA in their 40s. What that level is in a younger man actually gives oncologists an idea as to what their life risk of having life-threatening prostate cancer is.

To reduce the downstream harm from screening, oncologists need to be selective about treatment, says Loeb.

Active surveillance is really on the rise in both Europe and in the United States. Saving aggressive treatment for aggressive cancer, and encouraging active surveillance for low-risk disease can reduce the risks of overtreatment.

 
, assistant professor of urology and population health at New York University (NYU) Langone Medical Center, discusses screening determinations for prostate cancer.
 

Dr. Stacy Loeb on Considerations for Screening in Prostate Cancer

​Stacy Loeb, MD, assistant professor of urology and population health at New York University (NYU) Langone Medical Center, discusses how prostate cancer screening has evolved and what is on the horizon.

Screening has been shown to have significant benefits, including reducing metastatic prostate cancer and prostate cancer deaths, says Loeb. However, it hasn’t always been used correctly, she says.

Total PSA was historically used alone to determine if patients should undergo biopsy. However, it is now recognized that PSA should be viewed as part of a continuum of prostate cancer risk, says Loeb. There are many other factors such as family history and previously biopsy history that should be taken into account when determining if patients should undergo screening.

Patient selection is really important and screening efforts should be focused on men with a long life expectancy, she says.

There are also new tests that are more specific than PSA including the 4K score and the Prostate Health Index tests.

Stacy Loeb, MD

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