New clinic opens for high risk prostate cancer patients

Ganesh Palapattu, M.D.

Ganesh Palapattu, M.D.

mCancerPartner sat down recently with Ganesh Palapattu, M.D., an associate professor of urology, and a urologic cancer surgeon and scientist, who directs the new High Risk Prostate Cancer Clinic. This clinic was established to offer multidisciplinary evaluation and personalized management for men who are diagnosed with aggressive disease.

mCancerPartner: Dr. Palapattu, how do you define ‘high risk’ for men with prostate cancer?

Dr. Palapattu: Our clinic defines high risk as men with a high PSA or high Gleason grade or high clinical stage. But going beyond the numbers, these are men who are likely to suffer from their prostate cancer.

mCancerPartner: What are the key features of the clinic?

Dr. Palapattu: At our clinic, patients see different specialists on the same day in the same place, and are offered a consensus expert opinion. Elsewhere, the patient experience might be to see a specialist who advises on one treatment, then to see another specialist on another day who recommends a different treatment, and so on. You can imagine that this sort of interaction isn’t very helpful to many patients and their families. It’s often confusing and can be frustrating. Men diagnosed with this sort of disease – and their families – are looking for answers, are looking for help. In our view, consensus expert opinion can help provide comfort and confidence in choosing an appropriate treatment plan.

So what we offer is a central clinic where men can receive multidisciplinary evaluation and care – in other words, see a urologic cancer surgeon, a radiation oncologist, a medical oncologist as well as have access to a translational pathologist and clinical trials, all in one space. It’s really all done in one visit and in one place.

Another key feature is our state of the art genetic testing. We offer free cancer genome sequencing to every man seen in the clinic, along with several recently introduced predictive genetic tests. In addition, we have access to cutting edge clinical trials that they would not necessarily be able to get at other places. And finally, we are very interested in helping patients and their families after they are done with treatment. Our team of social workers and other physician extenders offer support services to help our patients and their families as they deal with the challenge of a cancer diagnosis and the ramifications of treatment.

mCancerPartner: Are clinics for men with high risk prostate cancer common?

Dr. Palapattu: We believe the clinic, with one stop shopping, consensus opinion, free cancer genome sequencing, genetic testing and survivorship services, is probably among the first of its kind in the country.

mCancerPartner: Why is understanding the genetic structure of an individual’s tumor important?

Dr. Palapattu: There’s growing evidence that isn’t so surprising, that not everybody’s cancer is the same and that these differences are largely driven by genetics, the DNA sequence of cancer. This kind of information could be helpful because we would know what kinds of drugs might be more effective, and conversely what drugs may not be as effective for a specific patient. It’s a precision type of medicine we are employing here in the clinic.

mCancerPartner: What happens at the first clinic appointment?

Dr. Palapattu: Prior to the first appointment, our team of specialists, including a translational pathologist, will have reviewed the patient’s records and pathology slides and assessed the patient for candidacy in clinical trials as well as for cancer genetic sequencing and predictive genetic testing. At the first clinic appointment, the patient will meet with a urologic oncologist and a radiation oncologist who, in most cases, after evaluation will provide a consensus expert opinion regarding a specific treatment plan. Consultation with a medical oncologist is also available if needed. Thereafter, if a patient chooses treatment with us, we would initiate the plan.

But, what I want to emphasize is that we treat patients not diseases. I believe this comes across in the way we interact with our patients and their families. Men diagnosed with high risk prostate cancer – disease we believe is likely to harm them – are scared, and their families are similarly frightened and anxious, and rightfully so. Our goal is to try to get them back to the way they used to be, as much as we can and as fast as we can. To do this, we leverage both our scientific knowledge and world class clinical care. In addition, and as importantly, we are committed to treating all of our patients and their families with compassion and kindness. Ultimately, we believe that we can help men with aggressive prostate cancer achieve better outcomes than what has been traditionally thought possible. I think there are few places better poised to do this than the University of Michigan.


UIn the High Risk Prostate Clinic at the University of Michigan Comprehensive Cancer Center, our mission is to focus treatment and discovery on those who need it most. We do this by offering advanced cancer care, individual genetic analysis and precise treatment planning for men with high risk prostate cancer in order to optimize the probability of achieving a long lasting cure.


CCC 25 years button150x150The University of Michigan Comprehensive Cancer Center’s 1,000 doctors, nurses, care givers and researchers are united by one thought: to deliver the highest quality, compassionate care while working to conquer cancer through innovation and collaboration. The center is among the top-ranked national cancer programs, and #1 in Michigan for cancer patient care. Seventeen multidisciplinary clinics offer one-stop access to teams of specialists for personalized treatment plans, part of the ideal patient care experience. Patients also benefit through access to promising new cancer therapies.