Other than skin cancer, prostate cancer is the most common cancer among men. The National Cancer Institute says about 165-thousand cases have been diagnosed this year.
With early detection, treatment is often successful.
New diagnostic technology is helping patients in the Lansing area avoid prostate surgery, or undergo surgery earlier when needed.
Local urologists say a new imaging process called prostate MR fusion has been available to them for about a year.
Dr. Eric Stockall of Capital Urological Associates explains that this new technology starts with magnetic resonance imaging of the prostate. The MRI shows areas of the prostate that are suspicious for being cancerous. “What we do is we then do an ultrasound of the prostate," Dr. Stockall explains, "and the MRI image is fused onto the ultrasound image so that when we put the ultrasound probe into the rectum to scan the prostate that we’re then able then to identify the area that was seen on the MRI and biopsy that area specifically.”
Dr. Stockall says MR fusion is making prostate biopsies more accurate.
Dr. Rafid Yousef of the Lansing Institute of Urology is also using prostate MR fusion. He says in the past, elevated prostate-specific antigen, or PSA numbers, in men between the ages of 45 and 70 might have called for a biopsy. He continues that this new diagnostic technology will reduce the number of biopsies performed, “and hopefully pick up the more aggressive lesions that are worth treating as compared to picking up lesions that potentially could be inconsequential in treating prostate cancer.”
Dr. Yousef says that rather the removal of the prostate, this detection can lead to less invasive treatments called focal therapy. That could come in the form of cryofreezing or radio frequency oblation, leaving the prostate intact.
Some of his patients, he says, have been able to avoid removal surgery. “Instead of taking the prostate out," Dr. Yousef says, "we can just watch the PSA every four months, perform a rebiopsy in one year, and those patients have been absolutely spared unnecessary treatment (such as) surgery or radiation therapy.”
Avoiding removal is desirable. Along with the risks of any surgery, prostate removal can result in incontinence and erectile disfunction.
Dr. Yousif says MR fusion technology should be offered to men who have previously undergone prostate biopsies that failed to show cancer but still have rising PSA levels.
While some patients are avoiding surgery, others are getting earlier diagnoses and undergoing prostate removal sooner, which hopefully improves the likelihood of success. On the day I spoke with Dr. Eric Stockall, he was preparing to perform two prostate removal surgeries. “Approximately, now, about half the patients who are diagnosed with prostate cancer, we actually treat with what’s called active surveillance, which is following the patients closely over time," Dr. Stockall concludes. "Many of these patients won’t have aggressive cancers requiring treatment. That being said, the other half of patients have very aggressive, fast-growing cancers and need to be treated, sometimes quite urgently.”