Prostate cancer diagnosis with MRI. MRI-guided prostate biopsy after PSA test. 3
PSA test must be followed by MRI before prostate biopsy. Multiparametric prostate MRI helps avoid unnecessary biopsy. MRI helps to target biopsy precisely. Dr. Anton Titov, MD. In modern time, how many men are usually diagnosed with prostate cancer? Prostate cancer diagnosis in Western countries, in advanced medical systems. Dr. Mark Emberton, MD. Yes, this year in Europe alone there will be a million men who have prostate biopsy. That doesn’t mean they all have prostate cancer. About 40% of men will test positive on biopsy. Some patients will be having biopsies at another time. So half a million men a year in Europe will be diagnosed with prostate cancer. Now that is obviously set to change. One of the great things about MRI is that if prostate MRI negative, we might be able to avoid doing a biopsy. just like if a mammogram is negative in breast cancer screening. At the moment there’s nothing standing between PSA test and prostate biopsy. It’s a linear relationship. If a man is at risk for prostate cancer, all we can do is biopsy. Prostate MRI sits between the PSA test and biopsy. Multiparametric prostate MRI will tell us whether to biopsy, and how to biopsy prostate gland. Question of “whether to biopsy” is important. It might be that with good MRI we might be able to avoid 30 – 40% of unnecessary prostate biopsies. Dr. Anton Titov, MD. This is very important because prostate biopsy is an invasive procedure. It has its own risks as any invasive medical intervention. Dr. Mark Emberton, MD. Correct! MRI of prostate will then add to the financial savings that many countries. Most countries are struggling to meet the health care needs of their population. Interventions that actually keep people out of the medical system allow us to do less expensive diagnostic procedures. MRI of prostate often results in fewer unnecessary diagnoses. Prostate MRI have the potential to save millions millions of pounds, dollars or euros. Overdiagnosis is difficult concept in cancer. Everybody thinks that all cancer needs to be found. But in prostate cancer, because it’s so common, not all cancer has tube found. Most men will get prostate cancer if they live long enough, but they will not die of it. Not all prostate cancers are destined to cause a problem. So you can avoid diagnosing men with prostate cancer who don’t need to be diagnosed. Then you cab save maybe 10 – 20 years of healthcare costs that would have been used up, wasted on that individual. Unnecessary cancer treatment may have even actually caused harm.
How can patients avoid mistakes when dealing with a medical problem? Leading doctors share wisdom: