madman
Super Moderator
Is the biopsy needle more dangerous than the cancer itself? In this episode, Dr. Geo sits down with Dr. Mark Emberton, Dean of Medical Sciences at UCL and a global leader in urologic oncology. We dive deep into the "See and Treat" revolution—a massive shift in prostate cancer care that moves away from "blind" invasive biopsies toward precision imaging like MRI and PSMA PET scans.
Dr. Emberton explains why many prostate cancers found through traditional methods are "biological non-events" that never needed treatment, and how younger men (ages 40-50) can better navigate their diagnosis. We also discuss the future of focal therapy, the role of AI in radiology, and the groundbreaking "Transform" study that aims to change prostate screening forever.
WHAT YOU'LL LEARN IN THIS EPISODE:
* Why a normal MRI (PI-RADS 1-2) might mean you can skip the biopsy entirely.
* The difference between "visible" tumors on imaging vs. microscopic disease.
* How PSA density acts as the crucial "tie-breaker" for indeterminate results.
* The future of "See and Treat": Targeting lesions while avoiding surgery side effects.
* Why tumor location (Anterior vs. Posterior) changes your treatment options.
* How AI and new magnets are making MRI screening cheaper and faster.
EPISODE TIMESTAMPS:
00:00 – The dangers of the biopsy needle
02:45 – Innovation in urologic oncology
06:45 – Rising cancer rates in younger men
10:15 – How MRI prevents unnecessary biopsies
12:30 – The PI-RADS "Traffic Light" system
13:45 – PSA Density: The diagnostic tie-breaker
16:30 – Diagnosing without a biopsy
21:00 – AI's role in faster, cheaper MRIs
26:45 – Visible vs. Invisible Cancer: What matters?
35:30 – The "Transform" Study & global screening
42:45 – PSMA PET Scans: Pre-biopsy utility
48:00 – Focal Therapy: Saving the "clockwork"
56:45 – Why tumor location (Anterior) matters
58:30 – Lifestyle and the "Teachable Moment"
01:03:30 – Final advice for patients and policy
