Most of my readers will know that I adamantly recommend against the prostate biopsy procedure other than in a handful of special circumstances. Instead, what I recommend is the Advanced Prostate Cancer Risk Assessment (APCRA) which includes a live, real-time scan of the prostate.
In conjunction with a range of tests, our expert professionals produce a detailed analysis and report which assesses the likelihood of there being prostate cancer that has the potential to be life-threatening. But the cost of my APCRA is $4075. Not everybody can afford that straight off the bat.
A Less Expensive Alternative
For years now I have suggested that a less expensive alternative to my APCRA is a three Tesla multi-parametric MRI scan. Although that scan cannot prove whether a tumor in the prostate is aggressive and potentially life-threatening, what it can do is to prove that there is no chance of you being in immediate danger. So it can eliminate any need to worry or have any further assessments or procedures done.
Recently a new study was published in the Lancet. It proved that the three Tesla multi-parametric MRI is actually twice as accurate in predicting the presence of prostate cancer as a prostate biopsy. It’s taken only four or five years for conventional medicine to produce a study that confirmed my judgment about MRI.
Researchers have shown that an MRI picks up 93% of aggressive cancers, compared with 48% for a biopsy. The biopsy, which removes a sample of tissue for lab testing, often misses the tumor altogether.
Around 100,000 men are sent for a biopsy each year in Britain following blood tests which suggest prostate cancer might be present.
But many will not have an aggressive tumor – or cancer at all – and run the risk of developing sepsis or urinary problems through the unnecessary exploratory surgery.
Some men with no cancer or harmless cancers are sometimes given the wrong diagnosis. They are treated even though this offers no survival benefit, according to Dr. Hashim Ahmed of University College London.
Biopsies Are No Good
Biopsies are also notoriously poor at detecting aggressive cancer. They miss half of deadly cases and over-diagnose in 25% of cases.
Now, a new study by UCL and the Medical research Council (MRC), has shown around 25,000 men could be spared a biopsy and needless treatment if they were scanned first.
The study involved a trial of 576 men across 11 NHS hospitals. “Prostate cancer has both aggressive and harmless forms,” explains study author Dr. Hashim Ahmed.
“Our current biopsy test can be inaccurate because the tissue samples are taken at random. This means it cannot confirm whether a cancer is aggressive or not and can miss aggressive cancers that are actually there.
“Because of this some men with no cancer or harmless cancers are sometimes given the wrong diagnosis and are then treated even though this offers no survival benefit and can often cause side effects,” said Dr. Hashim Ahmed.
Why MRI Scans
MRI scans can reveal the size of the tumor, how densely packed the cells are and how well it is connected to the blood stream. All of these indicate how aggressive the cancer is.
In the study, scanning correctly diagnosed almost all of the aggressive cancers (93%). Biopsies, on the other hand, correctly diagnosed only 48%. For men who had a negative MRI scan, 9 out of 10 either had either no cancer or a harmless cancer – an accuracy rate far higher than surgery.
Men whose scans came back negative would instead be monitored by the doctors rather than undergoing surgery.
“We are searching for better ways to diagnose prostate cancer, the most common cancer in men in the UK, since PSA alone is an imperfect test,” said Professor Ros Eeles, Professor of Prostate Cancer Genetics at The Institute of Cancer Research, London.
“This study provides groundbreaking data that the addition of a multi-parametric MRI can be used in the diagnostic pathway after PSA to eliminate the need for many men to even consider a prostate biopsy.
Currently, an MRI prior to prostate biopsy is not the standard of care internationally.
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