Posted on 04/05/2024 10:06:37 PM PDT by ConservativeMind
MRI of the prostate, combined with a blood test, can help determine if a prostate lesion is clinically significant cancer, research suggests
A new meta-analysis suggests doctors and patients can avoid unnecessary prostate biopsies by combining MRI of the prostate findings with prostate-specific antigen (PSA) density.
To doctors, clinically significant prostate cancer (csPCa) is prostate cancer that has a high chance of threatening a patient's life.
MRI of the prostate can provide some of this information. Still, a biopsy is traditionally needed to determine how aggressive the cancer cells look. This study tested a new approach: combining MRI-based prostate imaging reporting and data system (PI-RADS) scores with prostate-specific antigen (PSA) density to determine which cancers were likely to be clinically significant without including information from a biopsy.
PI-RADS scores the prostate lesion from 1 (highly unlikely to be clinically significant) to 5 (cancer is highly likely to be clinically significant). PSA density (PSAD) is the PSA blood level divided by the prostate's volume (as determined by MRI)..
The new study did the analysis on data from 72 previously published studies of men with prostate cancer, including their PI-RADS results, prostate-specific antigen density testing, and determination of clinical significance from a biopsy.
The meta-analysis gave them a dataset of more than 36,000 patients to determine if their earlier findings at BWH held in a more diverse sample set. They found that prostate biopsies may be unnecessary for patients with a PI-RADS under 4 and a PSAD below 0.10 ng/ml2. The researchers found that using specific PI-RADS and PSAD cutoffs, doctors could confidently skip 50% of biopsies while only missing 5% of clinically significant cancers, or they could skip 30% and only miss 3%.
(Excerpt) Read more at medicalxpress.com ...
Those bites hurt.
Yes they did but it was necessary and 12 years later, I feel great.
Having been on Prostate cancer ‘active surveillance’ for over a decade I’ve had more biopsies than I can count. The doctors have told me that the biopsy ultrasound probe is small, just like a ‘two finger’ exam compared to the normal one finger exam. I can tell you for sure, that it’s more like a football. At least that makes it pointed at the ends, so it goes in easier. I’ve had so many of those that I’m getting as much practice at passing a football as Tom Brady.
I did accuse the doctors of removing my Prostate, taking one needle zap at a time. I was informed that each zap removes only one billionth of the Prostate, so that might take a while.
That said, the latest round of MRI guided cryogenic ablation seems to have done its job, and I may get no more football practice.
A few years ago I had a prostrate biopsy on Thursday. Saturday morning I thought I had the flu. Sunday I woke up with chills and basically felt like I was going to die. I finally figured out what was going on. Called the urologist and they said go immediately to the ER. I did. Spent the day getting antibiotics through every orifice available. Almost admitted. Now I’m on the road to having to do another biopsy. Don’t think I’m going to participate this time. If I die of prostrate cancer that’s just the way it is.
The MRI with a PSA score should work really well for you.
If they can’t do the MRI, you can arrange for an MRI that you can get out of pocket.
“The MRI with a PSA score should work really well for you.
If they can’t do the MRI, you can arrange for an MRI that you can get out of pocket.”
Thanks. If it gets down to it I may try it.
One of my brothers says much the same thing.
My father died of prostate cancer and his brother also had prostate cancer but died of something else. One of my brothers had his prostate removed a few years ago, while the other is on active surveillance indefinitely. I've been lucky so far with only BPH (billiard ball size vs. normal walnut), but I'm sure I'll be getting more biopsies along the way.
Last fall I spent 5 weeks with a Foley catheter before getting a TURP operation, after which everything's fine again, at least for now.
Glad to hear that your ablation worked.
A Prostate biopsy is one thing I will not be repeating in this lifetime. Shove your finger up someone elses ass.
With a great surgeon, you would have been better off having your prostate removed because you wouldn’t have any long-term urinary or ED problems to deal with; and never have to worry a out actually getting prostate cancer.
One of my brothers took that option because his biopsy showed cancer developing (his surgeon did it right, BTW). My urologist recommended a TURP since a biopsy was negative for cancer. So far so good, for maybe the next ten years or more, if no cancer begins of course. I’ll be getting a PSA test and exam soon as a six-month follow-up, don’t know about regular biopsies yet. My other brother gets an annual biopsy, says pretty soon his prostate will be removed by those alone.
Yeah, but do you want to undergo definitive treatment (radical prostatectomy, external beam, or internal radiation, androgen deprivation, local treatment, or chemotherapy) without knowing as much as possible about the proven locations and aggressive status of any cancer?
The urologist can now digitally fuse data from MRI, and real time rectal ultrasound of prostate, to aim at suspicious hot spots in prostate for biopsy. Much more specific info can be gleaned from biopsy which helps decide what therapy is probably best. IMHO.
Urologists are starting to do transperineal prostate biopsy. They can put a rectal ultrasound probe up yours. But they don’t poke trough your rectum with needles to get to your prostate. Whole area is numb so essentially no pain. Rectal probe is uncomfortable but tolerable.
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