Podcast: Exploring the Risks and Benefits of Early Prostate Cancer Intervention
Dr. Thompson, with Dean Ford and Dr. Parekh, talks about early prostate cancer treatment.
Prostate cancer is one of the most common cancers among men, affecting more than half of males by age 80. Yet, early intervention can lead to complications that profoundly reduce quality of life.
In the latest episode of “Inside U Miami Medicine,” luminaries in the field of urology mull over the complex question: Does every prostate cancer diagnosis require immediate treatment?
Ian Thompson, M.D., professor emeritus at the University of Texas Health Science Center at San Antonio, has spent his career studying this conundrum. During the episode, he discusses seminal findings in large-scale trials that showed invasive treatments are associated with substantial risks, including urinary incontinence, erectile dysfunction and other, potentially life-threatening conditions.
“What took my breath away was the rate of bladder cancer after radiation,” Dr. Thompson said. “A threefold increased risk of bladder cancer…”
Dipen Parekh, M.D., founding director of the Desai Sethi Urology Institute and chief operating officer for UHealth–University of Miami Health System, expounded on the concept.
“Ideally, we want to find cancers that matter, cancers that are going to either hurt you or kill you. But unfortunately, in prostate cancer, we end up finding a lot of cancers that are indolent,” he said. “That means they’re not going to hurt you, nor are they going to kill you. But the word cancer often invokes automatic treatment. And then the treatment is far worse than the original disease itself. And that’s where the controversy lies.”
Managing low-grade tumors with regular monitoring—rather than invasive treatments like surgery and radiation therapy—is becoming a more accepted approach. This strategy aims to prevent unnecessary harm while intervening only if the cancer progresses and outweighs the risks of treatment.
The guests agreed that navigating these choices can feel overwhelming. Dr. Thompson emphasizes that shared decision-making is essential in prostate cancer care, and that these conversations often require time and expertise to fully explain the risks and benefits of early treatment versus active surveillance. Academic health centers, with their focus on education, research and patient care, are uniquely positioned to provide this level of comprehensive support.
Whether it’s exploring advanced treatment options or adopting a watchful waiting approach, having access to the best care ensures the right path forward for every patient.
Tune into the episode wherever you listen to podcasts or listen on Apple.
Tags: cancer research, Desai Sethi Urology Institute, Dr. Dipen Parekh, Inside U Miami Medicine, prostate cancer