Prostate cancer research is something I like to keep my beady eye on. With each advance we’re not only better able to diagnose the cancer early, we’re discovering ways to make sure each man gets the best treatment for him.
A promising development is a special type of MRI scan, says an editorial in the British Medical Journal.
And just as well because current evidence suggests that PSA (prostate specific antigen) testing provides only a small reduction in prostate cancer deaths. At the same time it exposes healthy men to the risk being treated for something they don’t have.
Developments are being worked on to get more accurate diagnosis and improve testing and treatment linked to prostate cancer screening.
Tools such as the Prostate Health Index and the 4Kscore, which work out cancer risk by looking at multiple biomarkers, may better illustrate the risk for men who choose screening.
But in the short term I’m laying money on the development of a new kind of MRI known as mpMRI or multiparametric magnetic resonance imaging. It examines the microscopic anatomy of the prostate while looking also at its function.
Best of all, data is collected into a standardised reporting system.
The mpMRI as a potential tool for identifying men with clinically important prostate cancer has been researched in a study called PROMIS.
This UK study enrolled 740 screened men with high PSAs who were going to have their first prostate biopsy.
The authors compared the diagnostic accuracy of mpMRI with both traditional biopsy and one which samples tissue every 5mm through the prostate. A total of 576 patients completed all three tests. 230 men (40%) had significant prostate cancer and an additional 178 men (31%) had clinically insignificant cancers.
The sensitivity and specificity of mpMRI for identifying this is so high that 27% of men with a negative mpMRI result avoided having a biopsy.
Reducing the need for prostate biopsy is a major step forward that will make a lot of men happy, and a lot of doctors too.
The mpMRI is a godsend for men at risk of prostate cancer, their families, and the doctors who care for them. And it’s just the latest that medical science has come up with.
We can all be encouraged by the development of mpMRI. In the controversial area of cancer screening its development, and the rigour applied to evaluating its use in men threatened by prostate cancer, gives me confidence of finding new and better strategies in this field.