Optimizing Prostate Cancer Care: A Collaborative Approach


Explore how David Morris, MD, FACS, and Benjamin Garmezy, MD, join forces to enhance patient outcomes in advanced prostate cancer through their innovative and collaborative precision medicine strategies.


David Morris, MD, FACS: Hello and welcome to this UroView® video series titled A Collaborative Approach to the Treatment and Management of Advanced Prostate Cancer. I’m David Morris, MD, FACP, a urologist from Nashville, Tennessee, president of Urology Associates. [I’m] part of a large urology group practice that partners with a local colleague, Dr Benjamin Garmezy, MD, who’s a director of genitourinary [GU] research at Sarah Cannon Research Institute [in Nashville, Tennessee,] and a practicing medical oncologist here in town. We’ll be discussing treatment approaches for metastatic hormone-sensitive prostate cancer and the benefits of shared decision-making between urologist and medical oncologist to ensure the best outcomes for our patients.

Our partnership came about very organically, largely driven by the growing data on collaborative team approaches, multidisciplinary care for men with prostate cancer, and other forms of GU cancer. It spun out of a GU oncology–focused virtual tumor board that was designed by one of my partners [and] included myself [and] Dr Garmezy, our radiation oncologist in town. And it focuses on all tumor types of prostate cancer, obviously a very high volume within that virtual tumor board. It became obvious that we were in consensus about a lot of the data.

It became very easy to begin sharing patients and understanding that there are certain times where I’m going to be in charge and certain times where Ben will be in charge. It’s been very collegial from that beginning because it grew organically, but it was something that focused on communication more than anything else. Ben, what do you think about how this is going?

Benjamin Garmezy, MD: I think it’s going well. And I think communication is critical. A lot of us trained at large academic centers where medical urologists and surgical urologists all work together and under the same roof, perhaps in the same hallway or maybe even in a multidisciplinary clinic. Well, in the community, a lot of the time we don’t have that luxury. We’re in different practices, potentially miles apart. Patients are traveling from one side of the city to the other side of the city. We have different EMRs [electronic medical records]. It can become a challenge. What I realized when I came to Nashville [was] we didn’t have a working tumor board. And as Dr Morris alluded to, one of our partners helped set us up when we realized this problem.

But we were able to create one virtually that fit the needs for our community so that we could better care for the patients in our community knowing that they don’t have to travel far away to another large center to get the exact same care. If not even what we like to think is the top-quality care you can possibly get because of the communication, but because of the access to each of the unique skill sets both of our groups provide with large clinical trial programs, advanced therapeutics, every cutting state-of-the-art therapy that we can get, whether it’s from a urologic oncology perspective or a medical oncology perspective. So the benefits are really for the patients foremost. That’s the most important. But we also feel confident in how we are providing care as well. I know as a medical oncologist practicing in the community that I have good partners and don’t feel like I’m lacking [them].

And I know that if I need a quick intervention for a procedure, I can get that done. I know that if I need expertise in the advanced early phases of the disease, I can rely on my urology colleagues to see those patients so that I can focus more on the patients who need chemotherapy and those types of therapeutics. And that allows us to divide our time appropriately [and] properly and provides us the time to see our patients and spend time with them in clinic. What do you think, Dr Morris, about some of the barriers outside of the fact that we’re far apart?

David Morris, MD, FACS: I think geography has become less and less of a barrier with the advent of virtual communication. As an example of this educational piece, the fact that we can be at totally disparate locations and yet still share educational content has made it that much easier to form this sort of partnership.

Text messages, secure messaging, email, the things that are done that are HIPAA [Health Insurance Portability and Accountability Act] compliant, [and] picking up the phone and talking to someone have become the key linchpin to us forming this sort of partnership, because I feel comfortable that if I have an immediate question, I can reach out and I’m probably getting a response the same day. There are barriers. There’s obviously territory between medical oncology groups and urology groups that offer dispensing within their four walls that have therapeutics that they’re buying and billing.

There are some financial issues, but honestly, there’s a place for both of us to come out ahead from a business standpoint and still be doing a better job of taking care of patients. And I think that’s been our focus, saying, “We’re going to put all that stuff on the back burner because we’re probably both going to be better as long as we do a good job of taking care of a patient.” And I think getting Ben involved early with my patients, even if they don’t need him for an extensive period up front, paves the way for down the road. If they need more of a medical oncologist and less of a urologist, they’re already established; they have a relationship.

And because Ben wasn’t fighting me tooth and nail at the very beginning to say, “I’m going to manage this throughout,” then it’s much easier to say, “We’re going to do some partnership up front, come up with a plan, and then down the road when we need to get back together, we can.”

Transcript is AI generated and edited for readability.

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