Dr Olivares on Considerations for Managing Prostate Cancer in the Community Setting

Ruben Olivares, MD, urologic surgeon, associate professor, Urology, Glickman Urological Institute, Cleveland Clinic, discusses considerations for managing prostate cancer in the community setting, particularly regarding early detection and screening.

Community-based oncologists play a vital role in early prostate cancer detection, especially through prostate-specific antigen (PSA) screening, Olivares begins. PSA screening remains crucial in reducing mortality, particularly in high-risk populations, such as African American men, who have a higher incidence and mortality rate from prostate cancer, he explains. African American men are 1.7 times more likely to be diagnosed with, and 2.1 times more likely to die from, prostate cancer than White men.

Early detection of prostate cancer increases the likelihood of offering less invasive treatments that reduce adverse functional outcomes, Olivares reports, adding that prompt referral to a urologist is critical, especially for patients with elevated PSA levels or other concerning symptoms. Once an abnormality is detected through PSA screening, Olivares advises referral to a urologist for further diagnostic evaluation, such as prostate MRI or biopsy. This approach ensures accurate staging and risk stratification of the disease, enabling more tailored treatment strategies.

Olivares goes on to state that, in the community setting, where access to advanced diagnostic tools and multidisciplinary care may be more limited than in academic centers, early referral pathways ensure that patients benefit from comprehensive management. This again emphasizes the importance of early intervention, as it may lead to a higher likelihood of curative treatment and potentially avoid the need for more radical interventions, which are often associated with greater morbidity, he emphasizes.

Providing a continued emphasis on early detection, advocating for the appropriate use of PSA screening, and prompt referrals for further evaluation are crucial for optimizing prostate cancer care in the community setting, Olivares concludes. This approach enhance accurate diagnoses and broaden the selection of treatment modalities that balance oncologic control with the preservation of quality of life.