Doctors have diagnostic tools to look for prostate cancer in men, but to be certain of a diagnosis, a biopsy of the walnut-sized gland is necessary.
It's a common cancer that strikes a great deal of older men. According to Legacy Health, "Other than skin cancer, prostate cancer has become the most common form of cancer and the second-leading cause of cancer death in American men."
Yet if you catch it early enough, there is a good chance of cure.
At Legacy Good Samaritan Medical Center in Portland, there is a new procedure that allows surgeons to look at the prostate in higher definition. This advancement can make biopsies more accurate.
It's called fusion biopsy and Dr. Bruce Lowe, an independent practitioner who works, on occasion, at Legacy Good Samaritan, is excited by the news.
"It's opening the door for what's called targeted focal therapy (TFT)," Lowe said. "The problem with prostate cancer is we have a relatively non-specific blood test, called PSA, that indicates there might be a cancer present. When that happens, the only option we have to really find out if there is a cancer there is what's called a random biopsy of the prostate."
According to Lowe, "We have no imaging studies that can actually identify where the cancer is, unlike breast cancer, where they have mammograms and ultrasounds — they can see tumors very easily — with prostate, the ultrasound is only about 40 percent accurate, so we just biopsy everything and we don't really know where the cancer is."
With the 3T MRI, doctors have a much more powerful machine and can gaze at the prostate with much more clarity.
"The 3T MRI has the ability to identify aggressive cancers in the prostate in over 90 percent of patients," Lowe added. "It's far better than anything we've had."
The machine allows doctors to specifically identify lesions and biopsy just the lesion. Lowe notes that biopsies can be performed through MRIs but it's a slow process that can take 45 minutes to do a single biopsy session.
"It's incredibly slow and incredibly expensive," Lowe said. "The fusion technology is basically a product of our digital age. You can take the information from the MRI, digitize it, then fuse that image with an ultrasound program that allows the ultrasound machine to operate within the images of the MRI."
This evolving technology allows doctors to test 15 cores (of the prostate) in 15 minutes. "It gives us the ability to be much faster and more cost efficient since MRI time is so valuable," Lowe said. "Theoretically, the patients will have fewer biopsies to be performed."
According to Legacy, "fusion biopsy also reduces the likelihood that additional biopsies will be required, and more effectively identifies regions harboring aggressive cancer while avoiding smaller, less significant cancers that don't require treatment."
This new technology is relatively new, according to Lowe. The 3T MRI has been available experimentally for about four years; commercially it's been available in the last 18 months. Fusion technology, on the other hand, has only been available, for general use, in the last year.
Lowe sees the benefits of focal therapy. "One, it reduces costs substantially for treatment," he said. "Two, it reduces side effects substantially. As a consequence, I think we're going to reduce mortality The Europeans have published a couple of interesting studies showing that, financially, treating cancer earlier is much cheaper than treating it later."
The future may hold some promising developments in the study of prostate cancer. "Yeah, in many ways this is an exciting time because there's so much research going on," Lowe said. "We're just slightly less than a generation away from specific DNA therapy, where you identify a genetic abnormality, you generate a gene probe and alter the DNA in the tumor. There are some tremendous studies going on right now."
Doctors have been looking for this advanced technology for decades. Lowe said, "We've been praying for this technology for the last 34 years, so this is a huge advance in the treatment of prostate cancer."