On this episode of On Call for Men’s Health, Dr. Michael Lutz talks with Dr. Jason Hafron about how prostate cancer screening has changed, and why PSA should be treated as a starting point, not a diagnosis. Dr. Hafron explains that early in his career, an elevated PSA usually led directly to biopsy. Today, the process is more thoughtful. A PSA result needs context, repeat testing, risk assessment, family history, and sometimes newer tools like biomarkers or MRI.
Dr. Hafron says the goal is not just to find prostate cancer. It is to find the prostate cancers that matter. Some men need treatment. Others can be safely monitored. That is why shared decision-making is so important. Patients need a clear plan. They also need to understand what each step means, what it does not mean, and what information would change the next decision.
A major theme is fear. Some men are anxious and want every test available. Others avoid screening because they fear biopsy, treatment side effects, or simply hearing the word cancer. Dr. Hafron says the best approach is to slow the process down and take it one step at a time. Screening starts with a blood test. An elevated PSA does not mean cancer. It means more evaluation may be needed.
The conversation also covers the growing role of blood-based biomarkers like IsoPSA. These tests can help identify men who are more likely to have clinically significant prostate cancer. They may also reduce unnecessary biopsies and help communities where high-quality prostate MRI is harder to access. Dr. Hafron is careful about the term “liquid biopsy,” because these tests do not diagnose cancer or replace tissue biopsy. They help decide who may need one.
Dr. Lutz and Dr. Hafron also talk about community screening, primary care, and the need to meet men where they are. That may mean workplaces, churches, barbershops, sporting events, or mobile health programs. Prostate cancer screening can also open the door to broader men’s health care, including blood pressure, diabetes, and cardiovascular risk.
Looking ahead, Dr. Hafron is encouraged by artificial intelligence, PSMA PET imaging, better biomarkers, advanced therapies, and research that brings clinical trials closer to patients. He believes the future depends on collaboration, better communication, and systems that help physicians provide consistent, high-quality care.
(00:00) Intro
(02:01) Why Dr. Jason Hafron Focused on Prostate Cancer
(03:23) How the PSA Conversation Has Changed
(06:34) Shared Decision-Making in Prostate Cancer Care
(08:31) The Role of Family in Treatment Decisions
(10:17) Managing Anxious and Avoidant Patients
(13:35) New Tools Between Elevated PSA and Biopsy
(15:51) Fear, Blood Tests, and the Limits of “Liquid Biopsy”
(17:45) Rethinking the Digital Rectal Exam
(19:28) Clinical Pathways and Quality of Care
(20:28) Helping Patients Navigate Online Information
(21:46) Blood-Based Tests and MRI Access
(23:43) Community-Based Screening and Men’s Health
(25:29) Primary Care’s Role in Early Detection
(27:32) What Urologists Need Before Referral
(33:47) AI, PSMA PET, and the Future of Detection
(38:32) What Gives Hope for Prostate Cancer Care
(41:42) New Therapies Beyond Hormone Treatment
(45:56) Balancing Work, Family, and Wellness
(47:22) Legacy, Systems, and Better Urology
The On Call for Men's Health Podcast is produced by JAG Podcast Productions: https://jagpodcastproductions.com/
