In his recent Virtual Hallway lecture, medical oncologist Dr. Keith Lawson walked clinicians through today’s most practical, evidence-based strategies for managing prostate cancer—from early detection to advanced disease. His session distilled a rapidly evolving field into clear guidance for confident, everyday practice.
Screen Smarter, Not More
Prostate cancer screening has moved well beyond a simple PSA check.
Dr. Lawson emphasized a risk-adapted approach that considers PSA trends, MRI before biopsy, and family history. MRI-guided biopsy is becoming standard and helps identify clinically significant disease while reducing unnecessary procedures.
When Localized Disease Is Found
Not every cancer needs immediate treatment.
Active surveillance remains the preferred strategy for low-risk patients and is expanding into favourable intermediate-risk cases. For those needing definitive therapy, decisions between surgery, radiation, and combination approaches should be tailored to patient characteristics—and ideally made through multidisciplinary discussion.
Biochemical Recurrence: Timing Matters
PSA rise after local therapy doesn’t always mean rushing into treatment.
Dr. Lawson highlighted the value of PSA doubling time, early salvage radiation, and the growing role of PSMA PET, which is shifting how recurrence is detected and managed.
Advanced Disease: Modern Sequencing Saves Lives
Therapies for metastatic prostate cancer have expanded dramatically.
In the hormone-sensitive stage, treatment intensification with agents like abiraterone, enzalutamide, apalutamide, or docetaxel significantly improves survival compared to ADT alone.
For castration-resistant disease, options broaden to include chemotherapy, second-line hormonal agents, PARP inhibitors for patients with DNA repair mutations, and emerging radioligand therapies.
Genetics Now Shapes Care
Dr. Lawson underscored the importance of germline genetic testing, particularly for men with high-risk or metastatic disease. BRCA1/2 and other DNA repair gene findings can guide treatment decisions and inform family screening.
Watch the Full Lecture
For a concise, practical walkthrough of screening decisions, treatment sequencing, and genetic considerations, watch Dr. Lawson’s full session on Virtual Hallway—available on-demand and eligible for MainPro+ credits.