"The groundwork of all happiness is health." - Leigh Hunt

Prostate cancer: can imaging replace repeat biopsies during lively surveillance?

If you've been diagnosed with low- or intermediate-risk prostate cancer, the excellent news is that you simply don't must treat it immediately. Because cancer is more likely to grow slowly (if in any respect), you possibly can monitor and treat cancer provided that it shows signs of progression. This is named lively surveillance.

More men are selecting lively surveillance, which requires a prostate-specific antigen (PSA) test and prostate biopsy to ascertain for tumor growth. This way you possibly can delay cancer treatment and its unwanted side effects – and possibly even prevent it. But repeat biopsies will also be painful and stressful, they usually include a small risk of infection.

Studying the effectiveness of mpMRI

An outstanding query is whether or not an mpMRI can replace a “confirmatory biopsy” that men typically get for a yr or more during surveillance to see if the cancer has spread. can be stable. The risk is that mpMRI may miss worsening cancer that a confirmatory biopsy would otherwise detect.

To investigate, a team of Australian researchers conducted a newly published experiment. the study. They enrolled 172 men with low- or intermediate-risk prostate cancer, and gave them mpMRI followed by prostate biopsy. Thereafter, the boys were followed for 3 years on an lively surveillance protocol. They get a PSA check every six months, an annual digital rectal exam, and an mpMRI scan at the tip of 1 and two years. If PSA and/or mpMRI results suggested progression of cancer, men underwent biopsy. If not, biopsies were delayed until the study was accomplished three years later.

Analyzing the outcomes, the team found that mpMRI scans were higher at stopping the expansion of cancer than detecting it. In particular, an mpMRI scan will detect clinically significant cancers (the type that require immediate treatment) that a subsequent biopsy will confirm in 50% to 57% of cases. Conversely, the chances are that the scan will show up accurately. Absence The rate of progressive cancer is between 82% and 86%.

Results and warnings

Based on these findings, the investigators concluded that men with a negative mpMRI scan could safely skip the one-year confirmatory biopsy. However, men should still get the usual three-yearly biopsy, he wrote, “because of occasional MRI-invisible tumors.” The team plans to follow the boys and present 10 years of knowledge sometime in the long run.

Other experts take a more cautious view. For example, Dr. Gershman expressed concern concerning the limited ability of mpMRI to detect clinically significant cancers during lively surveillance. But he added that despite its limitations, the scanning technology remains to be a great tool “that should allow for increased time between repeat biopsies in men otherwise at low risk of progression.”