Information for Patients
Knowing, Not Guessing, In Prostate Cancer Diagnosis
Each year, more than 217,000 American men are diagnosed with prostate cancer, making it the second most common cancer among men. One in every six men will contract it. But you can take comfort in knowing that the highly trained radiologists, scientists, physicists and technologists at VCU Medical Center’s Department of Radiology provide the most advanced, accurate and comprehensive MR imaging techniques now available for prostate cancer diagnosis and treatment.
The screening process
A prostate cancer screening usually begins with a periodic evaluation of a patient’s blood sample for PSA. A primary care physician or urologist may also begin with a digital rectal exam (DRE). In case of elevated PSA or a palpable prostate nodule, the urologist will perform an ultrasound-guided biopsy of the peripheral zones of the prostate, taking a total of six to 12 biopsy samples. The pathologist will then evaluate these samples and decide whether the histological features of the prostate specimens meet the criteria of diagnosing prostate cancer. If so, the cancer severity is graded using the Gleason Score (most ranging from 6 to 10). The higher the Gleason score, the more aggressive the tumor is likely to act and the less promising the patient’s prognosis.
Finding cancer is no longer a guessing game
Locating a tumor in a gland no larger than a walnut isn’t always easy. That’s why the accuracy of VCU Advanced Prostate Imaging can be so reassuring. When a PSA test indicates that cancer may be present and traditional TRUS procedures have been unsuccessful in locating it, MR imaging and a MR-guided biopsy can pinpoint the tumor and confirm the diagnosis so treatment can begin. VCU Medical Center is one of the few places in the United States where comprehensive MR imaging and MR guided biopsies for the prostate are performed. It’s all about knowing, not guessing.
MR-guided prostate biopsy allows precise placement of the biopsy needle under direct vision and allows tissue sampling with fewer passes of the biopsy needle. MR-guided biopsy of prostate cancer has been proven to be an accurate tool in confirming the diagnosis of prostate cancer, particularly useful for patients with prior failed transrectal US-guided biopsy (positive yield up to 60%).
know you're getting the best possible treatment
Treatment of prostate cancer is determined primarily by whether the disease is localized, locally advanced or metastatic. Generally speaking, localized cancer is treated by surgery, radiation or watchful waiting. Locally advanced cancer is treated mainly by radiation. Hormone therapy is used in patients with metastatic prostate cancer. Knowing the stage of the prostate cancer is crucial in order for the treating clinician to choose an appropriate therapy.
For patients with a history of prior radical prostatectomy or radiation therapy, an increase of the level of prostate-specific antigen (PSA, a blood protein secreted by prostate cancer) raises the possibility of recurrent tumor at the surgical bed or in the treated prostate. It is very important to know the location of the recurrence because the radiation oncologist is able to treat the recurrence by delivering a high dose of radiation to the specific target without radiating adjacent normal tissue.
The specialized abdominal radiologists at VCU Medical Center use the most advanced techniques to assess patients with suspected prostate cancer, and to evaluate patients who have been previously treated for recurrent disease. They work closely with radiation oncologists and urologists to provide the latest, most advanced diagnostic tools for prostate imaging.
To arrange an appointment for an MR of the prostate, call 804-237-6645. For an MR-guided prostate biopsy, call 804-828-4467.
Indications for Prostate MR at VCU Medical Center - Advanced MR prostate imaging, based on anatomic, metabolic and physiologic properties of prostate cancer, provide the best characterization of prostate cancer in individual patients. The list of indications for prostate MRI at VCU Medical Center is:
- Staging – Accurate staging of prostate cancer is important for choosing an appropriate therapy. MR imaging has been shown to be accurate in staging of prostate cancer and in detecting tumor spread outside the prostate gland.
- Improving biopsy yield – Recently, prostate MRI has been increasingly used in pre-biopsy patients. The information from the prostate MR will help urologists to perform a more targeted biopsy, resulting in a higher positive biopsy yield.
- Providing a roadmap – Minimally invasive and robotic surgeons are increasingly turning to preoperative MR imaging which would help provide a roadmap of the location of the tumor as well as the relationship between the tumor and the surrounding important structures. The roadmap will guide the urologist in resection of cancer while preserving essential delicate arteries and nerves that help maintain urinary continence and sexual function.
- Improving diagnosis – There are a growing number of patients with negative biopsies and elevated or rising PSAs, in whom prostate MRI is used to target regions for subsequent ultrasound-guided biopsy by urologists.
- Detecting recurrent cancer after radiation therapy or after radical prostatectomy – Advanced MR imaging using multiple parameters has been proven to be useful in the detection and localization of recurrent cancer. It is crucial for the treating radiation oncologists to know the exact size and location of the recurrence before starting new treatment.
- Monitoring “watchful waiting” patients – Most prostate cancers usually grow very slowly. Patients who have low Gleason scores, other medical complications or low grade tumors may wish to postpone treatment due to the side effects. MR imaging is an excellent noninvasive tool in monitoring the growth of the tumor over time.
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To schedule an appointment for a Prostate MRI, please call 804-237-6645 or for an MR Guided Prostate Biopsy, call 804-828-4467.