Alicia Morgans, MD, MPH, on PSADT awareness and prostate cancer treatment initiation

In this video, Alicia Morgans, MD, MPH, shares insights from the study “Impact of physicians’ awareness of prostate-specific antigen doubling time (PSADT) on treatment (Tx) decisions in high-risk (HR) biochemically recurrent (BCR) prostate cancer (PC),” which she presented at the 2025 American Society of Clinical Oncology Genitourinary Cancers Symposium in San Francisco, California. Morgans is a genitourinary medical oncologist and the director of the Survivorship Program at Dana-Farber Cancer Institute in Boston, Massachusetts.

Transcription:

Although the study highlights a correlation between known PSADT and treatment initiation, it doesn't establish causality. Could the observed treatment patterns be influenced by other factors, such as patient preferences, comorbidities, or access to care, that might be correlated with physician awareness of PSADT?

This study was really a 1-time chart check and not a longitudinal analysis. There was no randomization to balance between known and unknown PSA doubling times to really understand how to sort of force these numbers to be known or unknown and equalize the groups and absolutely, in a non-longitudinal type follow-up, we are not able to establish causality. There are absolutely other factors that can come into play when it comes to treatment decisions for patients and so things beyond knowing or not knowing the PSA doubling time could have contributed to patients not necessarily having intensified treatment, even though it was potentially an option for them. And of course, as you mentioned, patient preferences often come into play when we're having these conversations. I think physician awareness of options also may come into play. I think physician preferences and our thoughts around a patient's willingness to accept [adverse events] also come into play. If we don't ask a patient about his preferences, we actually don't know them, and so we shouldn't make these assumptions. But I think sometimes physician say, "Well, I don't think this patient would really want to deal with those [adverse events], so I'm just not even going to get into that conversation." And that's really the wrong thing to do. It is important for us to ask patients whether they want to intensify or not, and not make assumptions. But that also could be coming into play.

This transcription was AI generated and edited by human editors for clarity.