In this podcast, Dr. Jeff Twidwell, a urologist (retired) and Dr. Jim Lehmann, an internist (retired) join the podcast to discuss various aspects of prostate cancer from a unique personal and professional viewpoint. 

Enjoy the podcast.

Objectives:
Upon completion of this podcast, participants should be able to:

• Describe prostate specific antigen and what levels are considered normal.
• Identify when to include PSA testing and to what specific patient populations.
• Determine when a referral to a urologist is needed for further patient evaluation.

CME credit is only offered to Ridgeview Providers & Allied Health Staff for this podcast activity. Complete and submit the online evaluation form, after viewing the activity.  Upon successful completion of the evaluation, you will be e-mailed a certificate of completion within approximately 2 weeks. You may contact the accredited provider with questions regarding this program at  [email protected].

To receive continuing education credit for this activity - click the link below, to complete the activity's evaluation.

CME Evaluation

(**If you are listening to the podcasts through iTunes on your laptop or desktop, it is not possible to link directly with the CME Evaluation for unclear reasons. We are trying to remedy this. You can, however, link to the survey through the Podcasts app on your Apple and other smart devices, as well as through Spotify, Stitcher and other podcast directory apps and on your computer browser at these websites. We apologize for the inconvenience.) 

DISCLOSURE ANNOUNCEMENT 

The information provided through this and all Ridgeview podcasts as well as any and all accompanying files, images, videos and documents is/are for CME/CE and other institutional learning and communication purposes only and is/are not meant to substitute for the independent medical judgment of a physician, healthcare provider or other healthcare personnel relative to diagnostic and treatment options of a specific patient's medical condition; and are property/rights of Ridgeview Medical Center & Clinics.  Any re-reproduction of any of the materials presented would be infringement of copyright laws. 

It is Ridgeview's intent that any potential conflict should be identified openly so that the listeners may form their own judgments about the presentation with the full disclosure of the facts. It is not assumed any potential conflicts will have an adverse impact on these presentations. It remains for the audience to determine whether the speaker’s outside interest may reflect a possible bias, either the exposition or the conclusions presented.

Ridgeview's CME planning committee members and presenter(s) have disclosed they have no significant financial relationship with a pharmaceutical company and have disclosed that no conflict of interest exists with the presentation/educational event.

Thank-you for listening to the podcast.

SHOW NOTES: 
*See the attachment for additional information.
  
Diagnosis
- Call to action - "I will not miss a case of cancer of the prostate." (Dr. Jim Lehmann)
- Main risk factors:  age, black/hispanic ethicity, genetics
- Evidence based moment  (see show note attachment for link to referenced article)
Screening
- PSA (prostate specific antigen) - level greater than 4.0 ng/ml is "abnormal"
- Age adjustment
- PSA levels reduced with 5-alpha reductase inhibitor
- PSA increases 0.75 ng/ml per year
- Stop screening when life expectancy is less than 10 years
- Shared decision making
Next Steps in Diagnosis
- Biopsy (template and MRI)
- MRI
- 4K score blood test
- Ultrasound
- Gleason score and grade
- Decipher testing
- PSMA-PET scan
Prostate Cancer Care Team
- Urologists
- Primary Care
- Radiation oncology
- Oncology
Treatment
- Observation
- Surgery (open, DaVinci, Laparoscopy)
- Radiation
- Hormonal (androgen deprivation)
- Cryosurgery
- Brachytherapy (prostate radioactive seeds)
- Chemotherapy
- Immunotherapy (advanced prostate cancer)
- Proton therapy (up and coming)

Thanks for listening.
Please check out the additonal show notes for additional resources.