Advances in prostate cancer diagnosis and treatment Dr Nick Mehan

About this episode

Host: Michelle Odayan (My Health Academy) Guest Expert: Dr. Nicholas Mehan (Urological Surgeon specializing in prostate cancer, robotic surgery, and laser ablation) Episode Summary Dr. Nicholas Mehan provides an overview of how prostate cancer care has evolved over the past two decades. The discussion covers the shift away from broad PSA screening toward targeted early detection, modern diagnostic tools (mpMRI and transperineal biopsy), updated Australian clinical guidelines (PCFA & RACGP Red Book), and harm-minimizing treatments like focal laser ablation and robotic surgery. Key Discussion Topics & Highlights • The PSA Screening Dilemma & Historical ContextPre-PSA Era: Before blood testing in the 1990s, prostate cancer was typically detected at late, metastatic stages with high mortality. • Overdiagnosis & Overtreatment: The introduction of PSA testing increased early detection but led to 20–40% overdiagnosis of indolent, low-risk cancers, subjecting many men to aggressive treatments that caused incontinence and erectile dysfunction. • Guideline Re-evaluation: Confusion following the 2012 US Preventive Services Task Force (USPSTF) recommendation against PSA testing led to long