By Allan Bucka Jones
PRIDE Health Columnist
The standard technique now used by most doctors to confirm prostate cancer is transrectal ultrasound (TRUS)-guided biopsy, commonly referred to as biopsy of the prostate gland. However recently, magnetic resonance imaging / ultrasound-guided fusion biopsy (MRI-US), is an approach being recommended by urologists to detect prostate cancer. This method combines two existing methods for viewing structures inside the body, to create a powerful new tool, which research suggests may diagnose prostate cancer more accurately and precisely than the standard biopsy of the prostate.
In a 2012 study in The Journal of Urology by a team at the National Institutes of Health, in the United States, researchers recruited 195 men who had rising PSA levels, suggesting they might have prostate cancer, but who had undergone conventional biopsies that returned negative results. In the study, each man underwent an MRI-US fusion biopsy combined with a conventional biopsy. The researchers discovered that 73 of the men, or more than one-third, had prostate cancer, and that 21 of the men had high-grade, or potentially deadly, tumors. Significantly, the MRI-US technique detected all of the high-grade cancers, while standard biopsies missed 12 of them, or more than half. Other studies have demonstrated similar findings.
MRI-US may offer additional advantages over conventional biopsies. Compared with transrectal ultrasound (TRUS)-guided biopsy, MRI-US detects more tumors in the anterior, or front, of the prostate, according to a 2014 study in BJU International. Also, MRI-US has the edge in finding tumors in men who have enlarged prostate glands (though the detection rates of both methods diminish with increasing prostate volume).
Despite growing enthusiasm for MRI-US, proponents of this new biopsy method emphasize that, for now, it should be conducted in addition to, not instead of, a conventional systematic mapping biopsy. That’s because while larger tumors are relatively easy to spot on an MRI, controversy remains over how to identify smaller tumors. And even doctors who are most optimistic about MRI-US, acknowledge that MRIs sometimes miss potentially deadly tumors; as many as 15 to 20 percent in some reports.
So who are the men eligible for this new screening for prostate cancer? Some suggest that, in the near term, the technique might be most appropriate for men who have had one or more negative prostate biopsies, despite having consistently elevated PSA. Some say it may also be useful for the biopsies used to follow men enrolled in active surveillance programs. The information on tumor location is retained for future reference, so it is easier to track the cancer and identify any changes that occur, a finding that could indicate the need for immediate treatment. If any of the above description fits your situation, talk to your doctor about doing the MRI-US prostate cancer screening.
One in eight men in Canada is affected by prostate cancer. Black men have even higher rates.
The prostate gland in men, transition from a quiet non-growing gland, to a problematic growing gland at around age 50. An enlarged prostate can cause a man to have frequent and urgent need to urinate. This enlarged prostate is referred to, as benign prostatic hyperplasia (BPH). The benign description means BPH is not cancerous. A man with BPH will not necessarily develop prostate cancer.
For all men 45 years old and more, the initial screening for prostate cancer is vital because once detected, 90% of prostate cancer cases are treatable. This first screening process, includes a prostate gland examination and a blood test, and should be part of a man’s annual check-up. So if you are 45 or older, you should do the PSA test, at least once a year.
Prostate cancer is a serious matter…It is time for men to take responsibility and get screened for this devastating disease. If you are 45 years old, or older, and never been tested for prostate cancer, please make an appointment with your doctor, to do your prostate screening test as soon as possible.
Allan Bucka Jones is a Health Promoter and Broadcaster. You can contact Allan Bucka Jones at email@example.com.