The only other cancer care pathway using MRI-guided biopsies is breast cancer, and the mammographers at the Huntsman Cancer Institute perform about 1-2 of these per week. Hardman, Lowrance, and Dechet are glad to be able to provide this same level of service and accuracy for prostate cancer.
It’s a far cry from being accurate. While TRUS biopsies find cancer 44% of the time, 1 studies have shown that there’s up to a 30% chance of a false negative. 2 In other words, 30% of the time when a biopsy is negative, cancer actually exists in the prostate, but the method is too flawed to find it.
If concerned about cancer, some urologists today order an MRI scan as a reference guide for their biopsies. MRI is more expensive than other scans like ultrasound, but it provides a detailed look at the prostate and is far superior at detecting areas of concern. This scan is done in advance, often weeks or even months before the biopsy, and it exists as a prior study on a computer screen. Since many prostate tumors measure just 5-6mm wide, trying to biopsy the tumor with 12 core needle samples and a computer image is still a proverbial (and literal) shot in the dark.
In the 30-minute procedure, the patient is given conscious sedation, and placed inside an MRI machine. Hardman positions a non-magnetic titanium needle with the help of very specific MRI scans. When he’s satisfied with the exact positioning, he takes three to four biopsies with the push of a spring-loaded trigger.
University of Utah urologists Will Lowrance, MD, MPH, and Chris Dechet, MD, lobbied the hospital and the radiology department to invest in the equipment and skills to perform real-time MRI-guided biopsies. “We have used prostate MRI in the treatment planning phase of managing prostate cancer for many years,” explains Lowrance. “Because of the high quality of our prostate MR images, it is only natural that its use would begin to migrate into the screening/diagnostic phase of prostate cancer.”
3 Hambrock T, Somford DM, Hoeks C, Bouwense SA, Huisman H, Yakar D, van Oort IM, Witjes JA, Fütterer JJ, Barentsz JO. Magnetic resonance imaging guided prostate biopsy in men with repeat negative biopsies and increased prostate specific antigen. The Journal of urology. 2010;183(2):520-8.
This is a somewhat stunning success rate, considering that these patients already had a negative biopsy. The American Urology Association was so impressed by these results that they’ve issued a new recommendation that MRI-guided biopsy be the second-line procedure for cancer detection. Hardman expects that these imaging-guided procedures will become more and more common as health care systems make the investment to offer them.
The American Cancer Society estimates that in 2017, there will be 161,360 new cases of prostate cancer that are diagnosed. They estimate that 26,730 men will die from prostate cancer in 2017 as well. Thankfully, the 5-year survival rate for prostate cancer that is either local or regional (i.e., has not metastasized far beyond the prostate) is nearly 100%. This makes detection of prostate cancer before it may metastasize an important goal.
Lowrance and Dechet first thought that they’d use this procedure with only a few patients they were very concerned about where traditional biopsies weren’t revealing cancer – about two or three patients a year. In the first year, however, Hardman has performed 43 biopsies in 35 men – about three to four a month.
There are three ways that the prostate biopsy procedure can be done:
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If any signs of cancer are present in the biopsy results, doctors keep the ball rolling. Conventional treatments vary, but all are damaging, as mentioned earlier. For example, three adverse side effects of prostate surgery or radiation therapy include:
We will discuss this in great detail later on or you can read all about it now in my book. (just click on the image)
The biopsy results showed that I didn’t have cancer. This was lucky because it reduced the chances of serious complications such as the spread of a cancer from the needle biopsy.
I have been taking Finasteride for the past year and a half. Initially my PSA scores went down but over the past year the have gone from 3.2 in 2015, …
Ron, regarding the info that you posted regarding prostate biopsy, do you have any studies that validate the following: „Not only can a prostate biopsy …
My view is simple. Improve your health and specifically your prostate health by making changes to your diet, lifestyle and more.
Now consider this: the findings from a 2009 European study indicate that 70 percent of diagnosed men have cancers that will cause them no harm whatsoever if left untreated. The study showed that just 1 out of 50 men would be saved through PSA screenings. The other 49 men would receive surgery with no benefit whatsoever, but likely suffer impotence or incontinence because of the treatments!