UCLA urologist Dr. Wayne Brisbane explains how micro-ultrasound compares with MRI for detecting prostate cancer, based on the Optimum Clinical Trial published in JAMA. This talk is ideal for men with rising PSA, newly diagnosed prostate cancer, or those considering biopsy, MRI, or active surveillance. Learn how micro-ultrasound works, what the research shows, and what it means for real-world decision making. ⸻ Chapters 00:00 Welcome & introductions 01:21 Why UCLA pursued micro-ultrasound 04:36 How micro-ultrasound works (high-resolution imaging) 09:42 PRI-MUS vs PI-RADS: scoring systems 12:58 Matching images to surgical pathology 18:02 Optimum Trial: design and purpose 22:52 Trial results: detection, accuracy & non-inferiority 26:42 Cost savings & workflow advantages 29:48 Clinical implications and future uses 31:59 Q&A: training, variability & AI 33:36 Q&A: PSMA PET with micro-ultrasound 34:58 Q&A: biopsy safety, tract seeding & implants 36:40 Q&A: negative MRI but rising PSA; availability 38:10 Closing comments and community updates ⸻ Summary Micro-Ultrasound Overview Dr. Brisbane explains UCLA’s work with high-resolution micro-ultrasound, which images the prostate at ~70 microns—far more detailed than conventional ultrasound. This allows clinicians to visualize abnormal duct patterns associated with prostate cancer, offering MRI-like detail in real time and without the limitations caused by metal hip implants or MRI scheduling delays. How Micro-Ultrasound Compares With MRI Micro-ultrasound can reveal structural changes in prostate tissue that correlate with Gleason patterns. Dr. Brisbane compares micro-ultrasound and MRI images of the same gland, demonstrating how higher resolution can help identify suspicious lesions. Unlike MRI, micro-ultrasound is performed directly in the clinic, with no claustrophobia and no ferromagnetic interference. PRI-MUS vs PI-RADS The PRI-MUS scoring system parallels PI-RADS for MRI. Using acoustic features—duct patterns, density, and shadowing—it helps categorize lesions from low risk to highly suspicious. UCLA continues to refine PRI-MUS to improve accuracy, including AI-assisted interpretation. Correlation With Pathology UCLA developed a specialized process to align micro-ultrasound, MRI, and whole-mount pathology from prostatectomy specimens. These comparisons validated how well micro-ultrasound can map tumor location and characteristics, forming the foundation for the Optimum Trial. Optimum Trial Findings The randomized Optimum Clinical Trial compared three approaches: micro-ultrasound alone, micro-ultrasound with MRI, and standard MRI-fusion biopsy. Results showed that micro-ultrasound was non-inferior to MRI for detecting clinically significant prostate cancer—and even trended slightly in its favor. Grade Group 2 and higher-grade cancers were detected at similar rates in all arms. Cost & Practical Benefits Replacing MRI-guided biopsy with micro-ultrasound can save roughly $445 per patient, reduce radiologist workload, and streamline scheduling. Micro-ultrasound may be especially valuable when MRI is not possible or not definitive. Clinical Applications Potential uses include: • Combining MRI + micro-ultrasound for improved targeting • Reducing the number of biopsy cores when both modalities identify the same lesion • Supporting active surveillance by tracking lesion changes • Improving diagnostic accuracy for men with rising PSA but negative MRI Audience Q&A Highlights Dr. Brisbane addresses: • Training challenges and the role of AI • How PSMA PET compares with MRI and micro-ultrasound within the prostate • The extremely rare risk of biopsy tract seeding • Advantages for men with hip replacements • Where micro-ultrasound is available in Southern California ⸻ About Prostate Forum of Orange County Prostate Forum is a patient-focused nonprofit serving Southern California and beyond. We meet online via Zoom on the 2nd and 4th Tuesday of each month at 5 PM Pacific, including during the holidays. Meetings feature presentations from leading urologists, oncologists, radiologists, and prostate cancer experts. If you’re watching this on YouTube, visit ProstateForum.org to sign up for our email list and receive links to upcoming programs. ⸻ Support Our Work Prostate Forum relies on community support to keep these educational programs free. You can contribute via: • PayPal • Personal donations (even $5 helps) • Qualified charitable distributions from IRAs • Vehicle or property donations through our partner program Your support helps us continue providing trusted, expert-led prostate cancer education.

What’s new in prostate cancer care in 2025? Dr. Matt Cooperberg of UCSF shares the latest updates on screening, active surveillance, focal therapy, and treatment decision-making. An essential talk for patients, caregivers, and clinicians looking to understand risk, avoid overtreatment, and benefit from the newest advances. 00:00 Introduction & About Dr. Matt Cooperberg (UCSF) 00:55 Prostate Cancer Today: Screening, Incidence & Mortality 15:45 Active Surveillance vs Watchful Waiting — Who Qualifies? 32:30 Focal Therapy Explained: HIFU, Cryotherapy & Beyond 38:56 Key Takeaways & Audience Q&A Key highlights include: • 📊 Screening trends: How PSA guidelines have swung over time, the risks of over- and under-diagnosis, and why smarter screening is critical. • ⚖️ Risk stratification: Understanding the spectrum from indolent “snails” to aggressive “rabbits,” and how tools like the CAPRA score improve decision-making beyond traditional NCCN categories. • 👀 Active surveillance: Why surveillance—not immediate treatment—is the standard of care for most low-risk cancers, and how MRI, confirmatory biopsies, and genomic tests refine monitoring. • 🔬 Focal therapy: The promise and limits of approaches like HIFU, cryotherapy, and laser ablation, and why they should be viewed as complements to surveillance rather than replacements for surgery or radiation. • 🧪 Genomic and AI testing: Where tools like Decipher, Polaris, and emerging pathology AI fit in—and where they don’t—when guiding patient choices. • 🏥 Second opinions & centers of excellence: Why outcomes vary widely, and the importance of seeking subspecialist expertise before choosing a treatment path. Dr. Cooperberg also emphasizes the urgent need to reduce racial disparities, personalize treatment decisions, and support men living with prostate cancer long after initial therapy. 👉 Whether you are newly diagnosed, considering active surveillance, or exploring focal therapies, this talk offers practical, evidence-based insights into today’s rapidly evolving prostate cancer landscape. ==== About the Prostate Forum ====== 📌 About the Prostate Forum of Orange County The Prostate Forum of Orange County (PFOC) is a nonprofit, volunteer-run support and education group for men and their families affected by prostate cancer. We host online support groups on the 2nd and 4th Tuesdays of each month, and feature presentations from medical experts on the 4th Thursday of most months. Our goal is to provide reliable information, expert insight, and a welcoming community where patients, survivors, and caregivers can share experiences and learn together. 💻 Learn More & Join Us 🌐 prostateforum.org 📺 Subscribe to our YouTube channel for monthly expert talks and fireside chats. 📧 Sign up for our free newsletter via our website to receive meeting updates. ⚠️ Disclaimer The information presented in this video is for educational purposes only. It is not medical advice. Always consult your healthcare provider before making treatment decisions. 🙏 Support Our Mission If you find our programs helpful, please consider supporting the Forum through donations or by spreading the word to others who may benefit.

Dr. Brian Wodlinger presents the latest developments in micro-ultrasound technology as a high-resolution alternative to MRI for prostate imaging. He discusses its applications, clinical validations, advantages over MRI, training, AI integration, and future directions. 00:00 Opening Remarks - Neal Berke, CEO Prostate Forum 01:57 Dr Wodlinger 25:01 Q&A 📌 Key Highlights 1. What is Micro-Ultrasound? • A new, real-time imaging modality operating at 29 MHz, offering 70-micron resolution. • Designed to overcome the limitations of conventional ultrasound (low sensitivity) and MRI (access, cost, claustrophobia, contraindications). 2. Why It Matters • Real-time imaging of prostate ducts (the origin of most cancers). • Enables office-based imaging, reducing reliance on expensive or delayed MRIs. • Can identify cancers missed by MRI, including small or non-contrast-enhancing lesions. 3. Validation & Clinical Trials • Validated through collaboration with UCLA, UHN Toronto, and others. • Optimum Study (multi-national, randomized, 680+ patients): o Proved micro-ultrasound is non-inferior to MRI/ultrasound fusion. o Micro-ultrasound showed higher sensitivity and NPV than MRI in some cohorts. • Studies in active surveillance and focal therapy planning also promising. 4. Applications • Screening men with elevated PSA. • Performing targeted and systematic biopsies. • Monitoring patients under active surveillance. • Guiding focal therapies (e.g., laser, cryotherapy). • Post-treatment recurrence detection and surgical planning. 5. Training & Usability • Exact Imaging offers a free, structured training program for physicians. • Over 300 systems in use worldwide, 100+ in the U.S., many in California. • Imaging and interpretation primarily performed by urologists, not radiologists, in the U.S. 6. Artificial Intelligence • AI is in development for image interpretation assistance. • Partner institutions include UCLA, UBC, University of Florida, and Queens University. • Focus on making image interpretation easier and more consistent. 7. Commercial Status • FDA-cleared since 2017. • Covered under existing ultrasound reimbursement codes. • Approximate system cost: $200,000, much less than MRI. 💬 Audience Q&A – Key Themes • Availability & Reimbursement: Already in clinical use; reimbursed as ultrasound. • Training Confidence: Robust program ensures urologists achieve diagnostic quality results. • Imaging Limitations: Cannot yet replace biopsy; histology still required. • AI & Second Opinions: AI tools and expert reading services developing; referrals possible. • Testicular Imaging & Other Uses: Promising for testicular pathology and residual volume scans. • Focal Therapy Implications: May strengthen support for focal therapy as a standard option. • Awareness & Education Gaps: Group emphasized need for early screening and better public communication (esp. PSA testing in men 50+). Mentioned • Website: exactimaging.com o Includes physician finder and contact info (info@exactimaging.com) • Follow-up Studies: MUSIC-AS and MUSIC-Screen (for surveillance and screening) ==== About the Prostate Forum ====== Prostate Cancer? You are not alone. The Prostate Forum of Orange County (prostateforum.org) is an all- volunteer organization that has been providing support to prostate cancer patients for more than thirty years. Our goal is to listen, to inform, and to educate, so that people learn to advocate for themselves and become active collaborators with their medical teams in managing their own treatment. The Forum hosts monthly online support meetings (via Zoom) on the second and fourth Tuesday of most months, beginning at 5:00 pm Pacific Time. At the Newly Diagnosed Group, every 2nd Tuesday at 5:00 pm Pacific Time, get help understanding your Prostate Cancer diagnosis. Learn what it means. Talk about your options. At the Advanced/Recurrent Group Group every 4th Tuesday, beginning at 5:00 pm Pacific Time, share your concerns and experiences, and find out what other Prostate Cancer warriors are saying and thinking. Learn about resources, advances, and breakthroughs - advanced treatment options are improving all the time. Monthly Presentations Experts in the treatment and management of Prostate Cancer share their knowledge and experience with us on the fourth Thursday of most months. All meetings are free and are open to anyone affected by prostate cancer – patients, family, friends. Our website address is: www.prostateforum.org

Dr. Jeremy Calais from UCLA provides updates on PSMA targeted theranostics (combination of therapeutic and diagnostic approaches) for prostate cancer. 00:00 Opening Remarks - Neal Berke, CEO Prostate Forum 01:39 Dr Calais 33:12 Q&A Links referenced in the Presentation: Radiology Connections at UCLA: https://www.uclahealth.org/medical-services/radiology/patient-resources/send-us-your-images-ucla-radiology-connections Theranostics Trials: https://www.theranostictrials.org/ Radiotheranostics: https://www.oncidiumfoundation.org/ Phase 3 trial using the copper based: https://clinicaltrials.gov/study/NCT06056830 https://www.urotoday.com/urinary-catheters-home/indwelling-catheters/complications/1134-urotoday/prostate-cancer/157739-clarity-receives-u-s-fda-fast-track-designation-for-cu-64-sar-bispsma-in-biochemical-recurrence-of-prostate-cancer.html https://www.claritypharmaceuticals.com/news/fda_amplify/ ## Key Points from Dr. Calais's Presentation: Dr. Calais discussed cancer molecular imaging, nanotechnology, and theranostics, with a focus on PSMA (Prostate Specific Membrane Antigen) targeted imaging and therapy. He explained how PET/CT imaging can be used for prostate cancer staging and restaging at different stages of the disease journey - from initial diagnosis to assess if cancer has spread beyond the prostate, during recurrence to locate where cancer has returned, and in advanced disease to evaluate therapy response and plan treatments. PSMA PET imaging targets a cell surface protein expression and has been shown to be superior to other imaging modalities like CT, bone scan, and other PET techniques in terms of sensitivity and diagnostic performance. The first PSMA agent was approved in December 2020, and now multiple commercial options are available from various vendors in the US and Europe. Dr. Calais noted that the different PSMA tracers behave similarly, with only minor differences, and are generally considered clinically equivalent. A limitation of PSMA PET is sensitivity - it still misses about 60% of micrometastases in pelvic lymph nodes that are too small to detect but can be seen under a microscope after surgery. Most prostate cancer cells express PSMA at high intensity, but about 10-15% do not express PSMA, which can be another limitation. Even with a negative scan, patients should still receive treatment if intended for cure, as microscopic disease may be present that's too small to detect. Dr. Calais reported that as of the previous Friday (March 28, 2025), the FDA approved Lutetium-PSMA therapy for metastatic castration-resistant prostate cancer patients pre-chemotherapy, meaning chemotherapy is no longer a requirement before receiving this treatment. Clinical trials are now exploring using PSMA therapy even earlier in disease progression, including in hormone-sensitive patients. Actinium is described as "the next big thing after Lutetium" - it's an alpha emitter that delivers much more energy in its radiation and may have more potent effects. Multiple trials are underway. Dr. Calais highlighted that combining PSMA therapy with AR (androgen receptor) directed therapy may be impactful, with promising data emerging. Regarding side effects, Dr. Calais confirmed the treatment is relatively side-effect free compared to chemotherapy, though it can cause fatigue and dry mouth in some patients. Salivary gland damage remains a side effect with no significant progress in prevention, and the damage is irreversible. However, with Previcto (Lutetium-PSMA), the effect is generally mild and rare. ## Additional Information: Dr. Calais mentioned that UCLA recently hosted a large PSMA conference with 300 attendees in person and 300 virtual participants, which included a patient sharing their experience with Lutetium-PSMA therapy. UCLA offers second opinions on PSMA scans and MRIs, with contact information provided during the meeting. When asked about PSA levels for PSMA scans, Dr. Calais explained that 0.2 is a reasonable threshold after surgery, but expectations should be adjusted based on PSA levels - at very low levels (0.1), one should expect potentially not seeing anything, while at higher levels (1.5), detection is more likely. Dr. Calais clarified that theranostics (therapeutic diagnostics) is used for other cancers beyond prostate cancer, but with different targeting agents specific to those cancers. ==== About the Prostate Forum ====== The Prostate Forum of Orange County (prostateforum.org) is an all- volunteer organization that has been providing support to prostate cancer patients for more than thirty years. The Forum hosts monthly online support meetings (via Zoom) on the second and fourth Tuesday of most months, beginning at 5:00 pm Pacific Time, and Monthly Presentations from experts on the fourth Thursday of most months. All meetings are free and are open to anyone affected by prostate cancer – patients, family, friends.

00:00 Introduction 01:41 About Prostate Forum 02:58 Dr. Calais presents 34:58 Q&A Overview Clinical theranostics research is revolutionizing prostate cancer treatment by combining diagnostics and therapy into a single approach. This innova-tive field uses advanced imaging techniques to precisely locate cancer cells, followed by targeted therapies that directly attack those cells. By personalizing treatment, theranostics enhances accuracy and effective-ness, minimizing side effects. Join UCLA's esteemed physician, Dr. Jeremie Calais, to discover cutting-edge advancements in theranostics research. Dr. Calais will provide updates on radiopharmaceutical imaging and therapy targeting the Prostate Specific Membrane Antigen (PSMA), PLUVICTO, LOCAMETZ, ILLUCCIX, PSOLUMA, PYLARIFY and more. Learn how these breakthroughs can make a significant difference in your journey and the future of prostate cancer care. ==== About the Prostate Forum ====== Prostate Cancer? You are not alone. The Prostate Forum of Orange County (prostateforum.org) is an all- volunteer organization that has been providing support to prostate cancer patients for more than thirty years. Our goal is to listen, to inform, and to educate, so that people learn to advocate for themselves and become active collaborators with their medical teams in managing their own treatment. The Forum hosts monthly online support meetings (via Zoom) on the second and fourth Tuesday of most months, beginning at 5:00 pm Pacific Time. At the Newly Diagnosed Group, every 2nd Tuesday at 5:00 pm Pacific Time, get help understanding your Prostate Cancer diagnosis. Learn what it means. Talk about your options. At the Advanced/Recurrent Group Group every 4th Tuesday, beginning at 5:00 pm Pacific Time, share your concerns and experiences, and find out what other Prostate Cancer warriors are saying and thinking. Learn about resources, advances, and breakthroughs - advanced treatment options are improving all the time. Monthly Presentations Experts in the treatment and management of Prostate Cancer share their knowledge and experience with us on the fourth Thursday of most months. All meetings are free and are open to anyone affected by prostate cancer – patients, family, friends. Visit the Prostate Forum website: prostateforum.org to: • Register to receive notices of meetings • Advocate for yourself: learn the language of prostate cancer. • Find resources for learning and treatment • Explore a library of a hundreds of expert presentations Our website address is: www.prostateforum.org

Sections: 00:00 Introduction 00:52 Dr. Ulaner - fun facts about him and his "students"! 03:10 Introducing the "key-lock" metaphor 18:52 Trials available at Hoag 27:55 Q&A with Dr. Ulaner 49:42 Wrap-up from Prostate Forum Overview Dr. Ulaner discusses the use of molecular imaging and therapy in treating prostate cancer, using a metaphor of keys and locks to explain the process. Cancer cells have specific targets (locks), and scientists develop binding agents (keys) linked to radioisotopes. Low-energy radioisotopes enable imaging via PET scans, while high-energy radioisotopes can kill cancer cells. At Hoag Hospital, clinical trials focused on prostate-specific membrane antigen (PSMA), a target on prostate cancer cells. The Polaris scan, using Fluorine-18, successfully detected metastatic disease not visible on conventional scans, aiding in accurate staging and treatment. Examples showed Polaris identifying hidden metastatic sites, allowing for targeted radiation therapy and significant PSA reduction. PSMA-targeted therapy with Lutetium-177, a high-energy emitter, demonstrated improved survival rates compared to standard care. Hoag Hospital's ongoing trials include imaging newly diagnosed intermediate-risk prostate cancer and using Copper-64 PSMA for higher-risk cases. These advanced techniques are enhancing prostate cancer treatment by providing precise and effective imaging and therapy options. ==== About the Prostate Forum ====== Prostate Cancer? You are not alone. The Prostate Forum of Orange County (prostateforum.org) is an all- volunteer organization that has been providing support to prostate cancer patients for more than thirty years. Our goal is to listen, to inform, and to educate, so that people learn to advocate for themselves and become active collaborators with their medical teams in managing their own treatment. The Forum hosts monthly online support meetings (via Zoom) on the second and fourth Tuesday of most months, beginning at 5:00 pm Pacific Time. At the Newly Diagnosed Group, every 2nd Tuesday at 5:00 pm Pacific Time, get help understanding your Prostate Cancer diagnosis. Learn what it means. Talk about your options. At the Advanced/Recurrent Group Group every 4th Tuesday, beginning at 5:00 pm Pacific Time, share your concerns and experiences, and find out what other Prostate Cancer warriors are saying and thinking. Learn about resources, advances, and breakthroughs - advanced treatment options are improving all the time. Monthly Presentations Experts in the treatment and management of Prostate Cancer share their knowledge and experience with us on the fourth Thursday of most months. All meetings are free and are open to anyone affected by prostate cancer – patients, family, friends. Visit the Prostate Forum website: prostateforum.org to: • Register to receive notices of meetings • Advocate for yourself: learn the language of prostate cancer. • Find resources for learning and treatment • Explore a library of a hundreds of expert presentations Our website address is: www.prostateforum.org

Dr. Kuftinec follows Greg, a representative prostate cancer patient, in his prostate cancer journey. She explains Greg's risk factors, his initial diagnosis, and some of the advanced technologies that are now available to Greg to monitor and manage his condition. Sections: 00:00 Introduction 02:30 Meet Greg - Overview of Prostate Cancer 06:00 Screening 17:40 Diagnostic Imaging 29:32 Q&A 55:10 About Prostate Forum The Prostate Forum of Orange County (prostateforum.org) is an all- volunteer organization that has been providing support to prostate cancer patients for more than thirty years. Our goal is to listen, to inform, and to educate, so that people learn to advocate for themselves and become active collaborators with their medical teams in managing their own treatment. The Forum hosts monthly online support meetings (via Zoom) on the second and fourth Tuesday of most months, beginning at 5:00 pm Pacific Time. You are not alone. At the Newly Diagnosed Group, every 2nd Tuesday at 5:00 pm Pacific Time, get help understanding your Prostate Cancer diagnosis. Learn what it means. Talk about your options. Advanced treatment options are improving all the time. Share your concerns and experiences. Find out what other Prostate Cancer warriors are saying and thinking. Learn about resources, advances, and breakthroughs at the Advanced/Recurrent Group Group every 4th Tuesday, beginning at 5:00 pm Pacific Time. Monthly Presentations Experts in the treatment and management of Prostate Cancer share their knowledge and experience with us on the fourth Thursday of most months. All meetings are free, and open to anyone affected by prostate cancer – patients, family, friends. Visit the Prostate Forum website: prostateforum.org to: • Register to receive notices of meetings • Advocate for yourself: learn the language of prostate cancer. • Find resources for learning and treatment • Explore a library of a hundreds of expert presentations

Advancing Precision Medicine: EpiSwitch PSE Prostate Cancer Screening Test Designed to confirm the presence of prostate cancer, the EpiSwitch Prostate Screening test, known as the PSE, confirms the presence of prostate cancer—whether symptoms are present or not. This technological advancement empowers urologists with important information when deciding if a patient should undergo a biopsy or opt for continued monitoring via active surveillance. Sections: 00:00 Introduction 01:00 Dr. Heaton - EpiSwitch 21:20 Q&A The Prostate Forum of Orange County (prostateforum.org) is an all- volunteer organization that has been providing support to prostate cancer patients for more than thirty years. Our goal is to listen, to inform, and to educate, so that people learn to advocate for themselves and become active collaborators with their medical teams in managing their own treatment. The Forum hosts monthly online support meetings (via Zoom) on the second and fourth Tuesday of most months, beginning at 5:00 pm Pacific Time. You are not alone. At the Newly Diagnosed Group, every 2nd Tuesday at 5:00 pm Pacific Time, get help understanding your Prostate Cancer diagnosis. Learn what it means. Talk about your options. Advanced treatment options are improving all the time. Share your concerns and experiences. Find out what other Prostate Cancer warriors are saying and thinking. Learn about resources, advances, and breakthroughs at the Advanced/Recurrent Group Group every 4th Tuesday, beginning at 5:00 pm Pacific Time. Monthly Presentations Experts in the treatment and management of Prostate Cancer share their knowledge and experience with us on the fourth Thursday of most months. All meetings are free, and open to anyone affected by prostate cancer – patients, family, friends. Visit the Prostate Forum website: prostateforum.org to: • Register to receive notices of meetings • Advocate for yourself: learn the language of prostate cancer. • Find resources for learning and treatment • Explore a library of a hundreds of expert presentations COME TALK TO US. WE'VE BEEN THROUGH IT.

Click "more..." to see links to each section. WHERE IS THE CANCER? Most of prostate cancer is invisible on MRI. To treat prostate cancer, doctors need to balance sparing healthy tissue and to preserve quality of life while minimizing the risk of leaving cancer behind. This is a challenging balancing act when it's not clear where all the prostate cancer is within the prostate. Fortunately, there is now Unfold AI. Sections: 00:00 Introduction to Avenda Health's Unfold AI 01:59 About Prostate Forum of Orange County PFOC 04:11 Unfold AI - Carolyn Reul 11:30 Dr. Kasraeian - Using Unfold AI 23:31 Q&A 59:59 Chat about AI in Medicine Unfold AI FAQ What is an Unfold AI Analysis? Using a patient's standard of care data (MRI, fusion biopsy, pathology and PSA) and artificial intelligence, Unfold AI generates a heatmap or Cancer Estimation Map (CEM) that visualizes where the cancer is in 3D, significantly outperforming MRI's ability to identify exactly where all the cancer resides in the prostate. Why does seeing the extent of cancer matter? It is important to know the location and how far cancer extends in order to make a truly informed decision about a patient's course of treatment. For example, the information provided by Unfold AI can aid your physician in surgical planning by providing a map of your cancer location relative to other important anatomical structures. Who qualifies for Unfold AI? Unfold AI is available for patients who have not started a prostate cancer treatment and have been diagnosed with Gleason Grade 2 (GG2) or greater. Unfold AI can provide a better understanding of cancer location and extent so patients and physicians can decide the best course of treatment. How do I get an Unfold AI analysis? Currently Unfold AI is only available in the United States. Visit our Find a Doctor (https://avendahealth.com/unfold-ai-finder/) page to find an available provider. We are working to make Unfold AI available throughout the United States. How much does Unfold AI cost? Unfold AI is a new prostate cancer test that is not yet covered by insurance. We are working to standardize prices across the country. We recommend speaking directly to your doctor to understand the cost of the analysis. How reliable is an Unfold AI analysis? Unfold AI is based on 100,000's of patient data points gathered over 10-years of research and validated in multiple clinical studies (https://avendahealth.com/category/publication/). These studies show that Unfold AI has superior accuracy against all current methods of determining cancer location and how far it extends. Our proprietary artificial intelligence algorithms used to analyze prostate cancer are FDA-cleared. How is Unfold AI helpful after a prostate cancer treatment has been selected? Unfold AI is an invaluable tool for planning and guidance of prostate cancer treatments. For example: • For active surveillance - Unfold AI can help guide repeat biopsies • For prostatectomy - Unfold AI can aid in surgical decision making and planning • For focal therapy - Unfold AI can determine how much of the prostate to treat • Lastly, for radiotherapy - Unfold AI can help determine what areas to focus radiation Prostate Forum of Orange County is a Southern California Prostate Cancer Support Group, with online (Zoom) meetings on the second and fourth Tuesday of most months, beginning at 5:00 p. Pacific Time. Our website address is: www.prostateforum.org

Dr. Ulaner provides an exciting update on the use of Prostate Specific Membrane Antigen (PSMA) technology in the management of Prostate Cancer. Prostate Forum of Orange County is a Southern California Prostate Cancer Support Group, with online (Zoom) meetings on the second and fourth Tuesday of most months, beginning at 5:00 p. Pacific Time. Our website address is: www.prostateforum.org

Dr. Metzger reviews the Clinical Practice Guidelines from the NCCN, containing recommendations for the prevention, diagnosis, and management of prostate cancer across the continuum of care. Prostate Forum of Orange County is a Southern California Prostate Cancer Support Group, with online (Zoom) meetings on the second and fourth Tuesday of most months, beginning at 5:00 p. Pacific Time. Our website address is: www.prostateforum.org

"This is not Your Father's Prostate Cancer." Dr. Marks talks about the revolutionary advances in detection of prostate cancer, and the target biopsy program at UCLA and elsewhere. Prostate Forum of Orange County is a Southern California Prostate Cancer Support Group, with online (Zoom) meetings on the second and fourth Tuesday of most months, beginning at 5:00 p. Pacific Time. Our website address is: www.prostateforum.org