Dr. Todd Morgan

Could we leave some lower risk prostate cancer cells behind too? Yeah. Yeah, even in margin negative patients. I mean, you've looked at those slides. Thankfully, it's a negative margin with like two cells between the cancer cell and in the margin. And so, yeah, I mean, those recurrences in that setting are lower risk. And that informs how we manage those patients, right?

Could we leave some lower risk prostate cancer cells behind too? Yeah. Yeah, even in margin negative patients. I mean, you've looked at those slides. Thankfully, it's a negative margin with like two cells between the cancer cell and in the margin. And so, yeah, I mean, those recurrences in that setting are lower risk. And that informs how we manage those patients, right?

These patients, if they ultimately do continue to have a PSA rise and they get radiation, they can get away with just radiation to the pelvis. Whereas the high-risk patients, again, they need more. They need radiation right to the prostate bed, probably nodal radiation, ADT. And so they're really different entities.

These patients, if they ultimately do continue to have a PSA rise and they get radiation, they can get away with just radiation to the pelvis. Whereas the high-risk patients, again, they need more. They need radiation right to the prostate bed, probably nodal radiation, ADT. And so they're really different entities.

These patients, if they ultimately do continue to have a PSA rise and they get radiation, they can get away with just radiation to the pelvis. Whereas the high-risk patients, again, they need more. They need radiation right to the prostate bed, probably nodal radiation, ADT. And so they're really different entities.

Yeah, well, so first I just want to speak to what you mentioned, which is like, I think we all take it personally. Actually deeply soul crushed when we see that, especially, I mean, sometimes we're kind of expecting it in really high risk patients, but patients with lower risk disease where we see that it's really, it hurts. And I remember in the last year or so speaking at a conference,

Yeah, well, so first I just want to speak to what you mentioned, which is like, I think we all take it personally. Actually deeply soul crushed when we see that, especially, I mean, sometimes we're kind of expecting it in really high risk patients, but patients with lower risk disease where we see that it's really, it hurts. And I remember in the last year or so speaking at a conference,

Yeah, well, so first I just want to speak to what you mentioned, which is like, I think we all take it personally. Actually deeply soul crushed when we see that, especially, I mean, sometimes we're kind of expecting it in really high risk patients, but patients with lower risk disease where we see that it's really, it hurts. And I remember in the last year or so speaking at a conference,

And I think I was addressing like, you know, why does not every patient in that scenario get referred to a radiation oncologist? Because if you look nationally, they don't. And I kind of hazarded a guess of like, there's a little bit is urologists, we actually, that feeling of like, oh my God, we kind of like are embarrassed.

And I think I was addressing like, you know, why does not every patient in that scenario get referred to a radiation oncologist? Because if you look nationally, they don't. And I kind of hazarded a guess of like, there's a little bit is urologists, we actually, that feeling of like, oh my God, we kind of like are embarrassed.

And I think I was addressing like, you know, why does not every patient in that scenario get referred to a radiation oncologist? Because if you look nationally, they don't. And I kind of hazarded a guess of like, there's a little bit is urologists, we actually, that feeling of like, oh my God, we kind of like are embarrassed.

and somehow we dropped the ball, even if the margins are negative and things are okay, but also the margins are positive, but we did something bad and we're just gonna push it off a little bit. I think most people can kind of, hopefully, maybe hopefully not, but I think most people can relate to that.

and somehow we dropped the ball, even if the margins are negative and things are okay, but also the margins are positive, but we did something bad and we're just gonna push it off a little bit. I think most people can kind of, hopefully, maybe hopefully not, but I think most people can relate to that.

and somehow we dropped the ball, even if the margins are negative and things are okay, but also the margins are positive, but we did something bad and we're just gonna push it off a little bit. I think most people can kind of, hopefully, maybe hopefully not, but I think most people can relate to that.

And Mac Roach, who's an amazing radiation oncologist, gets up and says, yeah, you guys, like you surgeons, you just have it all wrong. But the thought is, wow, we've gotten 98% of your cancer. We did this. And we made a huge dent in this disease. And our colleagues from Radiation Oncology are going to help, hopefully, with the last couple percent.

And Mac Roach, who's an amazing radiation oncologist, gets up and says, yeah, you guys, like you surgeons, you just have it all wrong. But the thought is, wow, we've gotten 98% of your cancer. We did this. And we made a huge dent in this disease. And our colleagues from Radiation Oncology are going to help, hopefully, with the last couple percent.

And Mac Roach, who's an amazing radiation oncologist, gets up and says, yeah, you guys, like you surgeons, you just have it all wrong. But the thought is, wow, we've gotten 98% of your cancer. We did this. And we made a huge dent in this disease. And our colleagues from Radiation Oncology are going to help, hopefully, with the last couple percent.

And I have really thought that was such a good comment. And we need to internalize that. And that was memorable for me. And I really have tried to internalize that. I actually use that terminology more now. That's mindset. Second is, you know, we see these patients and that, right, we're going to, your PSA is elevated. Yeah, that does suggest there's some cancer cells probably there.

And I have really thought that was such a good comment. And we need to internalize that. And that was memorable for me. And I really have tried to internalize that. I actually use that terminology more now. That's mindset. Second is, you know, we see these patients and that, right, we're going to, your PSA is elevated. Yeah, that does suggest there's some cancer cells probably there.

And I have really thought that was such a good comment. And we need to internalize that. And that was memorable for me. And I really have tried to internalize that. I actually use that terminology more now. That's mindset. Second is, you know, we see these patients and that, right, we're going to, your PSA is elevated. Yeah, that does suggest there's some cancer cells probably there.