In the third and final installment of our prostate-cancer trilogy with UCLA urologic oncologist Dr. Wayne Brisbane, Dr. Mills walks a 55-year-old patient through the modern treatment menu—active surveillance, focal therapy, surgery, and radiation—and why “having prostate cancer” doesn’t always mean “operate immediately.” Dr. Brisbane breaks down how doctors risk-stratify tumors (including what Gleason scores really mean), why PSA “ups and downs” can trigger anxiety, and how newer tools (from genomic tests to MRI-guided radiation) help personalize decisions. They also get real about side effects and recovery, from muscle-sparing prostatectomy techniques that can speed urinary control to the “sunburn in the bladder” sensations some men feel after radiation. The takeaway: treat the cancer the way it’s asking to be treated—and don’t be afraid to slow down, get second opinions, and choose the option that best matches your life.

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On Part 2 of our prostate cancer series, Dr. Mills welcomes back UCLA urologic oncologist Dr. Wayne Brisbane to walk listeners through what happens after a PSA bump — touching on how doctors use prostate MRI, biomarkers, and shared decision-making to determine who really needs a biopsy. Dr. Brisbane demystifies the MRI experience (yes, the loud, tight tube), explains what those 1–5 “PIRADS” scores actually mean, and breaks down modern biopsy options—including why the transperineal approach can lower infection risk. Then it’s on decoding Gleason scores, grade groups, and “risk stratification”— and explaining why, for many men, this is a highly treatable, often curable disease when caught early.

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In the first episode of our three-part Prostate Cancer series, Dr. Jesse Mills and Jordan Runtagh sit down with UCLA urologic oncologist and surgeon-scientist Dr. Wayne Brisbane to tackle the most confusing—and most important—starting point: screening. What does an “elevated PSA” actually mean, why is it controversial, and how do you avoid unnecessary panic (or unnecessary procedures) while still catching cancer early? Using a real-world “55-year-old patient journey,” they break down PSA as a prostate “thermometer,” when to repeat a test, what role MRI plays today, and how newer tools like urine biomarkers and micro-ultrasound are reshaping early detection—before the series moves on to diagnosis and treatment.

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