Dr. Katz on Determining Low-Risk Disease in Prostate Cancer

Aaron E. Katz, MD, FACS, professor, Department of Urology, NYU Long Island School of Medicine, chairman, Department of Urology, Winthrop Hospital, NYU Langone Health’s Perlmutter Cancer Center, discusses strategies for determining low-risk prostate cancer.

Patients with low-risk prostate cancer can be monitored with active surveillance rather than receive up-front treatment.

Patients who do not have multi-core or primary pattern 4 biopsies may have low-risk disease, says Katz.

Additionally, biochemical assays may factor into risk stratification as patients with a prostate-specific antigen (PSA) of less than 10 are eligible for active surveillance, explains Katz.

Some patients with PSA scores of greater than 10 can receive active surveillance because risk is also stratified by prostate volume, says Katz. MRI can often identify lesions in the prostate based on PI-RADS [Prostate Imaging Reporting & Data System] score and the volume of prostate.

From there, a patient’s PSA density can further stratify their disease. Patients with lower PSA density are more likely to derive a favorable response from active surveillance, concludes Katz.