Pearls & Perspectives: Mindfulness, Performance, and Prostate Cancer Care, with Phillip M. Pierorazio, MD

Welcome back to Pearls & Perspectives!

In this episode of Pearls and Perspectives, host Amy Pearlman, MD, is joined by Phillip M. Pierorazio, MD, Chief of the Section of Urology at Penn Presbyterian Medical Center, for a wide-ranging conversation recorded live from the Urology on the Beach conference in Miami, Florida. Blending clinical insight with personal perspective, the discussion moves fluidly from surgeon wellness and mindfulness to the evolving complexities of prostate cancer care.

Pierorazio reflects on how the COVID-19 pandemic prompted him to rethink sustainability in a demanding surgical career—sparking a deeper focus on fitness, nutrition, sleep, and mindfulness. He shares practical strategies for integrating wellness into daily life, emphasizing that mindfulness does not require meditation cushions or long workouts, but rather intentional presence woven into routine activities. The conversation also explores how normalizing these discussions in residency and surgical culture can improve learning, longevity, and patient care.

The episode then transitions into a candid, clinically grounded discussion of modern prostate cancer management. Pierorazio offers perspective on navigating an increasingly crowded diagnostic landscape, advocating for simplicity rooted in proven tools such as prostate-specific antigen (PSA), risk stratification, and prostate MRI. He addresses common real-world dilemmas, including incidental prostate cancer discovered during treatment for benign prostatic hyperplasia (BPH), PSA monitoring after contemporary BPH procedures, and whether tissue-resecting approaches are necessary for cancer surveillance.

Rounding out the conversation, Pearlman and Pierorazio tackle persistent myths around testosterone therapy and prostate cancer, highlighting how evolving evidence challenges long-standing dogma. The episode closes with a forward-looking discussion on faculty development, surgeon well-being, and emerging innovations in cancer imaging—underscoring the podcast’s central theme: caring for patients starts with caring for ourselves.