Ep. 200 Managing Biochemical Recurrence After Prostate Radiation with Dr. Amar Kishan

Biochemical recurrence of prostate cancer can be difficult to diagnose and treat. In this episode of BackTable Urology, where Dr. Aditya Bagrodia hosts Dr. Amar Kishan, a genitourinary radiation oncologist at UCLA, to discuss the complexities of biochemical recurrence and local failure after radiation therapy for prostate cancer. --- This podcast is supported by: Veracyte https://www.veracyte.com/decipher --- SYNPOSIS First, they evaluate alternatives to androgen deprivation therapy (ADT), the benefits and risks associated with ADT, and the role of genetic classifier tests. They also detail the goals of prostate-specific antigen (PSA) monitoring, PSA trends post-radiation, and advancements in PSMA PET scans. Then, the conversation highlights modern treatment options like targeted radiation, low dose rate brachytherapy, salvage radical prostatectomy, and focal therapy. Finally, the doctors emphasize personalized and multidisciplinary treatment plans as they hope to improve long-term outcomes for patients with prostate cancer. --- TIMESTAMPS 00:00 - Introduction 04:31 - PSA Levels Post-Radiation 13:21 - Local Recurrence and PSMA PET 21:29 - Explaining Radiation Effects to Patients 22:41 - Managing PSA Bounce 26:05 - Imaging and Biopsy Techniques 28:55 - Treatment Options for Local Recurrence 30:16 - Re-Irradiation and Focal Therapy 33:13 - Concluding Thoughts --- RESOURCES Veracyte https://www.veracyte.com/