As medicine becomes increasingly more precise, prostate cancer remains a stubborn outlier: screening methods are bogged down in controversy due to varying recommendations and, for many doctors, diagnosing the condition can almost feel like a shot in the dark.
A team of physicians at University Hospitals Seidman Cancer Center are working to alter that reality – using Magnetic Resonance Imaging (MRI) for patients who would have ordinarily gone straight to non-targeted biopsy. The goal of using MRI is to reduce uncertainty and unnecessary biopsies, procedures and treatments against low-risk cancer.
“We think that the MRI in many ways may be able to be equivalent to the colonoscopy for colon cancer, where patients may need a colonoscopy and depending on the results, they may no longer need further follow-up for several years,” says Lee Ponsky, MD, Urologic Oncologist at UH Seidman Cancer Center.
Prostate cancer is one of the most common types of cancer among American men and the risk goes up as men age. “The prostate is truly the last organ in the body that we are biopsying without hitting a visualized target,” says Dr. Ponsky. “There have been some advances in how we treat certain cases, but prostate cancer has been relatively stagnant over the past 20 years.”
In the past, doctors treated any prostate cancer patient, regardless of risk level, with surgery, radiation and/or medication. Over the last five years, researchers discovered low-risk prostate cancer patients can be successfully put under active surveillance (where doctors carefully monitor the patient for signs of disease progression), sparing them from unnecessary treatment after diagnosis. With the help of MRI, doctors can now better determine whether the individual has a low-risk or high-risk cancer. Additionally, for men with an elevated prostate-specific antigen (PSA) or family history, MRI can more clearly identify exactly where the cancer is located for a more precise and targeted biopsy.
Dr. Ponsky says the development and understanding of the MRI and how it can be used in the evaluation and management of prostate cancer is one of the greatest developments doctors have seen in the last several years.