How to improve urologists’ reporting of PSA doubling time in prostate cancer

In this video, Alicia Morgans, MD, MPH, shares ways to improve reporting of prostate-specific antigen (PSA) doubling time. She is an author of 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:

What strategies do you recommend to improve physician awareness and routine assessment of PSA doubling time in clinical practice?

I think the most important thing to improve our reporting of PSA doubling time is to remind clinicians why it's important to even calculate this number. This number is really most useful in the biochemical recurrent population of patients who have had previous treatment with either radiation or with surgery, and it's used for risk stratification, because patients who have a very long PSA doubling time don't necessarily need treatment, whereas those who have a shorter PSA doubling time may benefit more intensely from treatment, and these treatments we know can prolong the time to metastasis and potentially prolong survival, although that, I would say, is still being assessed. The most important thing is to be aware of this. The second most important thing, I think, is to understand where we can find online these reliable and valid PSA doubling time calculators, because the finding that some physicians are trying to calculate the PSA doubling time but really not getting it right and overestimating it also suggests that we're not really using the right tools to get to this number. Use of these online calculators, I think, can be really helpful rather than just guessing or doing mental math. The final thing would be, if it existed, or could be in some people's EMRs, is if there was a PSA doubling time calculator or algorithm within the electronic medical record, that would be a simple way for the system to pull and calculate these numbers, which are structured data, so this should be possible, and insert them directly into the medical record, into the note in patients in whom it's relevant. Again, this is really just relevant in the biochemical recurrent population, where we know that it's actually really important for making treatment choices.

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