Within oncology in general, we already know that LGBTQIA+ patients tend to have worse psychological function and quality of life during treatment, as well as worse overall outcomes. Within prostate cancer specifically, we are just learning that not only do men who have sex with men (MSM) and transgender women with prostate cancer have more depression and worse overall mental health, but they have very distinct sexual side effects related to therapy, which are just starting to be recognized. Even routine PSA testing value thresholds, based on cis-gender men, can be extremely misleading when it comes to recognizing prostate cancer in transgender women.

In this Educator Module, we hear from Sarah Traverso, PA-C, Farnoosh Nik-Ahd, MD, and Christi Butler, MD, about the unique side effects these subpopulations may experience during prostate cancer and best practices for having direct but sensitive shared decision-making conversations with patients.

Laura L. Mitchell, PA-C, also provides a wonderful example of health equity in prostate cancer, found within the U.S. Department of Veterans Affairs. Learn about the Veterans Affairs healthcare system practices for genetic and genomic testing, patient communication, and follow up that have led to better outcomes for Black veterans—who are 6 times more likely to have high-risk disease and who make up 40% of the prostate cancer cases diagnosed in the VHA—compared with their peers who use the private healthcare system.

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Sarah Traverso, PA-C
Northwestern Medicine

Sarah Traverso is a certified Physician Assistant who has been working in hematology and medical oncology since the beginning of her career. She received her Masters of Medical Science in Physician Assistant Studies at Midwestern University in Glendale, AZ. She currently practices in Genitourinary Oncology at Northwestern Medicine in Chicago, IL, managing adult patients with prostate, renal, urinary tract/bladder and testicular cancers.

Christi Butler, MD
University of California, San Francisco

Dr. Butler is an Assistant Professor in the Department of Urology at UCSF. She completed her residency in urologic surgery at UCSF and went on to complete a fellowship in Genital and Urinary Reconstruction with a focus on Gender Affirming Care at Oregon Health and Science University. Her practice focuses on gender-affirmation care and advancing our understanding of transgender health outcomes.

Farnoosh Nik-Ahd, MD
University of California, San Francisco

Dr. Nik-Ahd is a resident in the Department of Urology at UCSF. She completed her undergraduate and medical school at UCLA. Her research interests include understanding prostate cancer screening, diagnosis, and outcomes in transgender women. She aspires to be a urologist at an academic center to help care for transgender patients and continue her research efforts.

Laura Mitchell, PA-C
U.S. Department of Veterans Affairs

Laura Mitchell is a Hematology/Oncology Physician Assistant at the Atlanta VA Medical Center in Decatur, GA where she serves on the inpatient consulting team. She graduated from Mercer University Physician Assistant program in 2014. Upon graduation, she spent 5 years working in Primary Care in urban and rural settings of West Georgia then transitioned to inpatient Hematology/Oncology in 2020. Laura is a member of the American Academy of Physician Assistants, Association of Physician Assistants in Oncology, Georgia Association of Physician Assistants and African Heritage Physician Assistant Caucus. Laura serves as AAPA/APAO Medical Liaison to ASCO. Her vision as a physician assistant is to not only provide quality care but to also educate patients of their disease, complications, treatments including lifestyle changes, that will lead to an improved quality of life. In her spare time, she enjoys traveling, spending time with family and friends and cheering on her local sports teams.