NEW HOPE FOR POTENTIAL PROSTATE CANCER PATIENTS
The latest advancement
in prostate cancer detection is magnetic resonance imaging and ultrasound
fusion-guided biopsy, which offers benefits for both patient and physician.
It is estimated that
2014 will see more than 240,000 new cases of prostate cancer, and more than
29,000 deaths from the disease, according to the National Cancer Institute.
Jeffrey Nix, M.D.,
along with colleague Soroush Rais-Bahrami, M.D., both assistant professors in
the UAB Department of Urology, studied the MRI-US image fusion as fellows at
the NCI. Nix and Rais-Bahrami are two of a select few urologists in the United
States trained to utilize this technology; together they have five years'
experience using this approach.
Nix and Rais-Bahrami
say this new technology offers a "targeted biopsy," which refers to
direct tissue sampling of suspicious areas seen on MRI as opposed to the
traditional method of random, systematic sampling that is essentially performed
"blindly" in different "ZIP code" regions of the prostate.
"We are utilizing
prostate MRI and fusing it with real-time ultrasound for image-guided prostate
biopsies; this can detect prostate cancer with high accuracy, and it accurately
targets lesions of concern defined by MRI," Nix said. "This improves
overall detection compared to standard biopsy and, more importantly, has the
potential to give clinicians and patients a more accurate picture of their true
disease burden by allowing improvements in staging."
Studies of this new
technique, Nix says, have shown that it increases the overall cancer detection
rate, increases the high-risk cancer detection rate, and improves staging for
patients who are considering active surveillance, which is when your doctor
closely monitors your low-risk prostate cancer for any changes.
"The technique is
expected to be especially helpful in cases of men with a history of negative
biopsies who are still suspected of having cancer due to a persistently
unexplained elevated prostate-specific antigen level, patients with enlarged
prostates and patients being guided toward active surveillance for improved
staging," said Rais-Bahrami.
Rais-Bahrami adds that
MRI-US fusion-guided biopsy is a clinic-based procedure that can be performed
under local anesthesia; the patient's experience of this new biopsy versus
traditional biopsy without MRI guidance is the same, but with more accurate
outcomes based on the targeting approach.
"I have a patient
who had five previous biopsy sessions over the past seven years, and he's had
persistently elevated PSA, yet each biopsy came back negative,"
Rais-Bahrami said. "When he came to us and had the MRI-US fusion-guided
biopsy, we were able to target areas that we identified with our radiologists as
areas of concern, and one in fact came back as cancerous. This is probably
what's been there causing his PSA elevation all this time; however, it was
hidden to all these biopsy sessions over the past seven years."
"We've been
offering this technology at UAB for the last year, and we've seen a lot of
success," Nix said. "I have had several patients who were on active
surveillance, and the MRI-US fusion biopsy discovered significantly more
extensive disease. Those patients were able to go on to treatment and to cancer
cure. It turned out some patients had prostate cancer even after they had
multiple biopsies that came back negative; this enabled them to make more
informed decisions on appropriate treatment."
"This is the
first major advancement in prostate cancer detection in more than 30 years, and
it's a significant improvement," Nix said.
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