Prostate Cancer Detection

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There is a brand new tool for detecting prostate cancer that could make a huge difference in reducing the chances a cancer will be missed. The bottom line here is not only will cancers be detected more accurately and be less likely to be missed, but it could make it easier to avoid a complete prostate removal, a big, aggressive surgery. Instead, doctors could use targeted therapies that will just destroy the cancer spots, leaving the rest of the prostate intact. Jan winston had been followed by his doctor for a suspicious psa test, the blood test that is a marker for prostate cancer. That number kept rising. “He had done a previous biopsy that was negative. And then he talked about using this machine, and he found it with the biopsy using this mapping capability,” says Jan. Target scan helps minimize the problem of missed diagnosis on biopsy, particularly as a result of inadequate, inaccurate sampling of prostate tissue. Dr. Samir Taneja, Director of Urologic Oncology at NYU Cancer Center, says, “We’re probably missing about a third of cancers on the first biopsy go round so we believe this machine reduces that miss rate and that is something we would like to test in our upcoming clinical trial.”

The key: the computer generated 3-d map of the prostate with accompanying gps system-like guidance on where to biopsy the prostate. These are what set the machine apart from its predecessors. “Once it’s in the correct position, I release the trigger and it’s fixed. I could sit on this and it won’t move within the patient,” Dr. Taneja states.

 There is a soft, flexible needle that can bend easily. It’s how, with a fixed probe, a biopsy can be taken from exactly the same angle each time. “So that ensures us that the sampling is the same every time,” instructs Dr. Taneja The computer probe spins and takes pictures of the prostate at 5 mm intervals in two directions; it then creates an image of the prostate.

 Dr. Taneja adds, “The computer does all the work and then it tells you the exact coordinates at which the biopsy should be taken. The doctor simply dials them in, and inserts the needle, which goes through the exact paths for biopsy. This machine is so new it’s only in 5 medical centers around the country. But because it cost the same as traditional prostate machines it will probably end up being the standard of care." Jan’s PSA is down to zero, and he says he’s doing great.

“It’s very hard to project which ones are going to kill you quickly. So I was glad to have it removed and get rid of it,” recalls Jan. Doctors will be able to pinpoint suspicious areas that first biopsy as negative to reliably see if they become cancerous over time. It could also lead to the ability to treat only those areas of the prostate that are cancerous, for instance, but freezing the areas or using high frequency ultra sound. There is a clinical trial for those who have an elevated PSA or a risk for prostate cancer.

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