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BackTable / Urology / Podcast / Episode #112

Preliminary Complementary Data for Pairing mpMRI and the ExoDx Prostate Test

with Dr. David Albala

This week on BackTable Urology, Dr. David Albala, chief of urology at Crouse Hospital, and Dr. Jose Silva discuss the benefits and integration of biomarkers in prostate cancer diagnosis.

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Preliminary Complementary Data for Pairing mpMRI and the ExoDx Prostate Test with Dr. David Albala on the BackTable Urology Podcast)
Ep 112 Preliminary Complementary Data for Pairing mpMRI and the ExoDx Prostate Test with Dr. David Albala
00:00 / 01:04

BackTable, LLC (Producer). (2023, August 16). Ep. 112 – Preliminary Complementary Data for Pairing mpMRI and the ExoDx Prostate Test [Audio podcast]. Retrieved from https://www.backtable.com

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Podcast Contributors

Dr. David Albala discusses Preliminary Complementary Data for Pairing mpMRI and the ExoDx Prostate Test on the BackTable 112 Podcast

Dr. David Albala

Dr. David Albala is the chief of urology at Crouse Hospital in Syracuse, New York.

Dr. Jose Silva discusses Preliminary Complementary Data for Pairing mpMRI and the ExoDx Prostate Test on the BackTable 112 Podcast

Dr. Jose Silva

Dr. Jose Silva is a board certified urologist practicing in Central Florida.

Synopsis

First, Dr. Albala explains the history of PSA testing, which was the first test to screen patients for prostate cancer. He explains that in the past, positive PSA testing (>4 ng/mL) and digital rectal exams (DRE) could lead urologists to the decision to biopsy the prostate. He notes the importance of taking into account clinical risk factors, like age, family history, race, genetic markers like BRCA1/2. PSA cutoffs should also follow age-specific considerations, and PSA is not a specific test for cancer as some patients with biopsy proven prostate cancer can have normal PSA levels. Current USPSTF guidelines recommend PSA screening at age 45 in patients with risk factors (African American, positive family history, etc.) and at age 55 in patients without risk factors, but this should be subject to shared decision making.

Then, the urologists discuss the use of urine and blood biomarkers to determine whether a biopsy is necessary, as bleeding and infection are possible complications. Dr. Albala’s prostate cancer workup involves the following: a PSA level first, a repeat PSA level if the first one was between 2-10 ng/mL in a patient older than 50, and then the ExoDx exosome test. If the exosome test returns with a value greater than 15.6, he will perform an MRI fusion prostate biopsy. If the exosome test is less than 15.6, he will repeat the test in 6 months. He notes that benefits of the urine exosome test include affordability and reduction in the need for DREs and biopsies in patients without cancer.

Finally, Dr. Albala discusses future possibilities of layering biomarker tests and encourages early screening for prostate cancer. He ends the episode by emphasizing prostate cancer treatment should be personalized because many cases of prostate cancer are indolent and may be overtreated.

Resources

ExoDx Prostate Test:
https://www.exosomedx.com/

Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.

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