High-risk Prostate Cancer Clinic

Keyan Salari, MD, PhD, is the director of the High-risk Prostate Cancer Clinic within the Department of Urology at Massachusetts General Hospital, and a urologic oncologist with the Mass General Cancer Center. In this video, he discusses the innovative work he and his team are doing to advance prostate cancer patient care.

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Transcript

I direct the High-risk Prostate Cancer Clinic in the [Massachusetts General Hospital] Department of Urology, which is a special clinic for men who have been identified as being high risk for developing prostate cancer on the basis of either a strong family history of the disease or a specific genetic mutation. I work very closely with a team of genetic counselors in the Mass General Cancer Center, where we offer genetic testing for patients who either have prostate cancer and have a strong or compelling family history or those who don't have cancer but, for instance, might be family members of patients who have been identified as having a genetic mutation or have a relevant family history.

When we identify men who do have mutations that increase the risk for prostate cancer, we feel that these patients ought to be screened more aggressively or more intensely than the average patient in the general population, given that they have a higher risk of developing prostate cancer. So that's really what the High-risk Clinic is all about; it's a place where we perform enhanced prostate cancer screening for men who are at high risk either due to their family history or to a specific identified genetic mutation. This is an area in prostate cancer care that has been underappreciated, I think.

More recently there has been greater attention to the role of genetics and family history in the development of prostate cancer, and so we're seeing more of this happening around the country very recently—but it is a fairly unique clinic that we just started here at Mass General very recently.

And one additional unique aspect of [the clinic] is that we've opened a research study, a clinical study, where we are trialing enhanced screening protocols for men who are at high risk. So, whereas for the general population we typically use PSA [prostate-specific antigen] blood tests and prostate examinations to screen for prostate cancer, here we're incorporating additional blood-based biomarkers as well as multi-parametric MRIs [magnetic resonance images] of the prostate as a form of enhanced screening for this patient population that's at high risk, and we're essentially evaluating whether or not this screening protocol is effective for these high-risk patients.

One of the special things about doing research at Mass General is the collaborative team that we have, particularly in the genitourinary oncology group. We have an outstanding team of urologists and radiation oncologists and medical oncologists, pathologists and radiologists, all working together to focus all their attention on prostate cancer patients, among other genitourinary malignancies. And while we are of course striving always to deliver excellent clinical care, the other advantage of this group is that it forms a very powerful research team that is very collaborative.

The nice thing about Harvard Medical School and Mass General Cancer Center and all the neighboring institutions is that we have very strong collaborations and it allows us to really leverage everybody's expertise across the campuses to think of compelling research ideas and execute them.

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