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MRI-first strategy for prostate cancer detection proves deemed safe and effective
Medical Xpress / Charité - Universitätsmedizin Berlin / JAMA Oncology ^ | Dec. 19, 2024 | Charlie A. Hamm et al

Posted on 12/22/2024 10:40:16 AM PST by ConservativeMind

There are several strategies for the early detection of prostate cancer. The first step is often a blood test for prostate-specific antigen (PSA). If PSA levels exceed a certain threshold, the next step typically involves taking a tissue sample for analysis. Another option is to use magnetic resonance imaging (MRI) to search for signs of a tumor before deciding whether a biopsy is necessary.

Researchers conducted a study to determine whether this MRI-first approach is safe over the long term. Their findings show that this strategy poses no additional risk to patients for at least three years.

This approach, in which normal MRI findings are followed by regular urological checks, did in fact prove to be sufficiently reliable: The study found that 96% of patients with a normal MRI result would not go on to develop aggressive prostate cancer within three years. Aggressive prostate cancer was detected during further monitoring in just 4% of participants whose initial MRI findings had been negative.

The team included and monitored nearly 600 patients with suspected prostate cancer in their study. The subjects underwent multiparametric magnetic resonance imaging (mpMRI). This type of MRI detects multiple tissue-specific parameters, including the signal intensity of the prostate tissue, the blood flow or perfusion, and the diffusion of water molecules in the tissue.

"Tissue samples were taken only if the MRI showed suspicious findings in the prostate. Patients with normal MRI findings underwent regular urological check-ups for three years instead," Dr. Hamm says.

The authors say two other aspects are crucial. First, a high-quality MRI scan must be performed and analyzed by experienced experts; that means training more radiologists in the interpretation of prostate MRI scans and using standardized methods. Second, it is important to create a safety net for patients who do not undergo immediate biopsy.

(Excerpt) Read more at medicalxpress.com ...


TOPICS: Health/Medicine
KEYWORDS: cancer; mri; prostate; prostatecancer; safeandeffective
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This makes sense to me, as another recent study expecting to find early biopsies helpful to start early therapy was found to not provide much benefit to lifespan. It was believed that those who had biopsies that were positive were causing cancer cells to break away and colonize elsewhere, even before a treatment started.

However, this study still biopsied, so it would only delay that cancer migration a little whole longer.

We need to get more non-invasive tests, likely blood tests, to identify such cancer, instead.

1 posted on 12/22/2024 10:40:16 AM PST by ConservativeMind
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2 posted on 12/22/2024 10:40:55 AM PST by ConservativeMind (Trump: Befuddling Democrats, Republicans, and the Media for the benefit of the US and all mankind.)
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To: ConservativeMind

What, andvanced imaging of the internal body and its organs has medical benefits!? Who knew. /sarc


3 posted on 12/22/2024 10:43:03 AM PST by wildcard_redneck
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To: ConservativeMind

“safe and effective”

It’s an unfortunate choice to use that phrase unironically these days.


4 posted on 12/22/2024 10:44:21 AM PST by irishjuggler
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To: ConservativeMind

While = whole


5 posted on 12/22/2024 10:46:14 AM PST by ConservativeMind (Trump: Befuddling Democrats, Republicans, and the Media for the benefit of the US and all mankind.)
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To: ConservativeMind

Hm…

My PSA was over 6.
Urologist did an MRI that showed a tumor.
Urologist did a biopsy that showed cancer.
Urologist did a PSMA PET scan to show details.
Went on an androgen-deprivation medication.
Underwent 28 proton radiation therapy treatments.
My PSA is now 0.03.

Anyway, the MRI in my case came BEFORE the biopsy, so not sure what the author is talking about.


6 posted on 12/22/2024 11:00:03 AM PST by DennisR (Look around - God gives countless clues that He does, indeed, exist.)
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To: DennisR

Did insurance pay for the MRI? I doubt if mine would.


7 posted on 12/22/2024 11:06:42 AM PST by BipolarBob (As it was in the days of Noah they were feasting, drinking egg nog and celebrating Christmas.)
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To: ConservativeMind

My PSA went from a steady 2 to just over 4 so my MD being very vigilent sent me to a urologist who did the biopsys and sure enough found stage 1 prostate cancer. It was slow growing and the radium seeds and radiation took care of it 12 years ago. Pay attention guys and beat it.


8 posted on 12/22/2024 11:09:54 AM PST by Midwesterner53
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To: ConservativeMind

Recently developed urine test is as accurate as a biopsy and not harmful as a biopsy. Recently had this type of test


9 posted on 12/22/2024 11:11:55 AM PST by stockpirate (A group of baboons is referred to as a "Congress" of baboons.)
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To: ConservativeMind
We need to get more non-invasive tests, likely blood tests, to identify such cancer, instead.

Maybe they could call the blood tests PSA tests.

10 posted on 12/22/2024 11:34:27 AM PST by PAR35
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To: ConservativeMind

This approach sounds solid.

My PSA began increasing about 10 years ago above the acceptable levels. Digital exam indicated no detectable masses. Two biopsies ensued in the next two years which found ZERO cancer. My urologist finally ordered an MRI guided biopsy based on suspect areas of the prostate. They finally found a small sample of Gleason 3+3 tissue, which I decided to “treat” with active surveillance.

My PSA continued to increase so we ultimately decided on radical prostatectomy. PSA has been undetectable since.

In my opinion, repeated biopsies can results in gland inflammation as well as risk bacterial infections, since they go through the rectal wall to get the tissue samples. These outcomes can aggravate PSA, resulting in a spiral into false readings.


11 posted on 12/22/2024 11:38:27 AM PST by fwdude (Why is there a "far/radical right," but damned if they'll admit that there is a far/radical left?)
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To: fwdude

“In my opinion, repeated biopsies can results in gland inflammation as well as risk bacterial infections”

I ended up in the emergency room after a prostrate biopsy a few years ago. I spent the entire day getting antibiotics through every orifice in my body. I will be going through another prostrate biopsy tomorrow at 8:30 based on the results of an MRI. Getting old sucks.


12 posted on 12/22/2024 11:45:43 AM PST by suthener ( I do not like living under our homosexual, ghetto, feminist government.)
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To: DennisR

,,, had a CT scan, one MRI, a PET scan, a biopsy and another CT scan. Then 39 days of radiotherapy. Apparently the average prostate weighs around 40g. Mine was 85g. I would have had this for years. My oncologist told me last week that the latest blood test result came up undetectable. When I was getting radiotherapy I was talking with guys who had treatment spans of 20 - 25 days. I saw a few of them start and finish during my treatment time. Apart from the biopsy the process was brilliant... wonderful staff and amazing machines.


13 posted on 12/22/2024 11:55:56 AM PST by shaggy eel (A long way south of the border.)
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To: suthener

Best wishes to you. Biopsies suck. Glad I’m done with them. I had five total.


14 posted on 12/22/2024 11:57:17 AM PST by fwdude (Why is there a "far/radical right," but damned if they'll admit that there is a far/radical left?)
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To: DennisR


“My PSA was over 6.
Urologist did an MRI that showed a tumor.
Urologist did a biopsy that showed cancer.
Urologist did a PSMA PET scan to show details.
Went on an androgen-deprivation medication.
Underwent 28 proton radiation therapy treatments.
My PSA is now 0.03.

Anyway, the MRI in my case came BEFORE the biopsy, so not sure what the author is talking about.”

I had an MRI follow up to a kidney problem. It showed a prostate tumor. My blood showed a PSA of 270! Everyone thought I was done for. I had the biopsy and then was also put through radiation and testosterone deprivation shots. My PSA is now 0.04 and the doctors are saying I am a very rare case. Phew!


15 posted on 12/22/2024 12:53:45 PM PST by Pirate Ragnar
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To: shaggy eel
Apart from the biopsy the process was brilliant... wonderful staff and amazing machines.

Glad you are "clean" after all that!!!!

I too had a very good outcome (8 years ago) from radiotherapy. The only down side was I gained weight. His nurse had a very well stocked candy jar!

16 posted on 12/22/2024 12:56:13 PM PST by llevrok (“'Remember when' is the lowest form of conversation.” - Tony Soprano)
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To: ConservativeMind
My husband several years ago got his prostate removed. PSA was normal but the digital felt "different." Got the biopsy. Yes, cancer but still contained within the prostate. His personality being what it is he opted for removal as radiation wasn't a guaranteed fix and he would worry morning, noon and night about the what if.

The DaVinci robot was used and it's kind of amazing. The doc is in a booth across the room operating the robot. Google the pics. It's like an overhead spider with a bunch of arms doing the actual procedure.

Long story short, he's fine and fully functional. Every nerve down there was preserved.

Gentlemen, if you are avoiding "the finger" .... don't. The finger exam detected what the PSA test did not.

17 posted on 12/22/2024 12:58:54 PM PST by Lizavetta
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To: llevrok
,,, ha! I've stacked just under 5kg on since the end of treatment (end of October). Where it came from, I haven't got the slightest clue - and I'm about to consume turkey, salmon and duck over Christmas with new potatoes and, predictably, desserts.

Thanks for your warm wishes. We've both had our leases on life extended so we'll be OK to pay tax for a while longer.

18 posted on 12/22/2024 1:26:07 PM PST by shaggy eel (A long way south of the border.)
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To: PAR35

PSA doesn’t identify cancer, sadly.


19 posted on 12/22/2024 1:37:50 PM PST by ConservativeMind (Trump: Befuddling Democrats, Republicans, and the Media for the benefit of the US and all mankind.)
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To: irishjuggler

Well I would have to speak from experience. A MRI is waaaaaaaay less painful than a prostate biopsy.


20 posted on 12/22/2024 2:51:34 PM PST by midwest_hiker
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