CHAPEL HILL, N.C., September 30, 2026 - Prostate-specific antigen (PSA) blood tests have long served as the standard screening tool for prostate cancer.
Oncologists are now combining PSA screening with MRI and MRI-guided biopsies to locate prostate tumors more precisely. This approach can help physicians select more targeted treatments that limit side effects and preserve patients' quality of life.
Abigail "Abby" Pepin, MD, a radiation oncologist specializing in bladder and prostate cancers at UNC Lineberger Comprehensive Cancer Center, describes the importance of new advancements in treatment options for patients with localized and metastatic prostate cancer.
Abby Pepin, MD
"Our goal is to identify patients with clinically significant prostate cancer and provide the most appropriate treatment," Pepin said. "Localized prostate cancer is highly curable, but metastatic prostate cancer remains a serious disease that requires multidisciplinary management."
About 1 in 8 men will be diagnosed with prostate cancer over their lifetime, with Black men having a higher prostate cancer incidence and mortality compared to White men.
PSA screening is key for older men (>50 years old), those with a first degree relative diagnosed with prostate cancer at an early age, and Black men. If high PSA levels are detected, oncologists will take a closer look at the prostate and assess patients for other conditions that may raise PSA levels.
"PSAs can be elevated for reasons other than cancer, including benign prostate enlargement and inflammation," said Pepin. "Coupling PSA screening with MRI and MRI-targeted biopsies allows us to focus on areas of the prostate that appear more likely to harbor clinically significant cancer."
Once confirmed through an MRI and MRI-targeted biopsy, doctors will determine the best course of treatment depending on tumor size and spread. Localized prostate cancer is typically treated with radiation, hormone therapy, or surgical removal of the prostate gland.
Illustration Credit:
Keighley Reisenauer on BioRender.
A newer approach called radiopharmaceutical therapy is changing the way that oncologists approach cancer that has spread (metastasized) to other areas of the body.
Radiopharmaceuticals are designed to target a specific protein called prostate-specific membrane antigen (PSMA). The protein is present at high levels on many prostate cancer cells that have spread beyond the prostate, making it an important treatment target for metastatic disease.
Lutetium Lu 177 vipivotide tetraxetan is the latest PSMA-targeting therapy to be approved by the FDA. The radioactive medication binds to PSMA and delivers radiation directly to cancer cells, limiting damage to healthy cells surrounding the tumor.
"This is an area of ongoing research where we are exploring which patients would benefit the most from this type of therapy," said Pepin. "We are currently using these agents in the setting of metastatic prostate cancer and we are excited to expand our multi-disciplinary PSMA-targeted treatment programs for our patients living with prostate cancer."
Young Whang, MD, PhD
Dr. Pepin finds the research and clinical care environment extremely collaborative. She works closely with radiologist Blaine Mischen, MD, and genitourinary oncologist Young Whang, MD, PhD, in managing and administering the latest and greatest therapies for patients seeking prostate cancer care at UNC Hospitals.
"UNC has always been collaborative, even before multidisciplinary cancer care was widely implemented," said Whang. "Our multidisciplinary clinic was established in 1999 to help bridge the gap between specialties and expand clinical trials in this cutting-edge space."
