It’s the most common cancer in men, a quarter of a million of whom live with the disease in Britain alone. So the news this week that the use of MRI scans to detect prostate cancer could save many of them from unnecessary rectal biopsies could lead to a real revolution in diagnosing this deadly disease.
Traditional biopsies involve inserting a needle though the rectum to obtain samples of prostate tissue. Now, on the eve of a major clinical trial to find the best way of diagnosing the disease, experts say that this method may be leading to over-diagnosis and unnecessary surgery, as well as missing some cancers.
Medical researchers have started recruiting more than 500 men with suspected prostate cancer to take part in a trial to show whether non-invasive MRI scanning can be safely used to reduce the number of men having invasive biopsies. The £3 million government-funded Promis (Prostate MRI Imaging Study) trial will be based at several major cancer centres.
“We’re looking at whether a man can safely avoid a biopsy if his MRI scan proves negative,” says Richard Hindley, a consultant urologist at Basingstoke and North Hampshire hospital who is involved in the trial. “There’s an increased realisation that the traditional biopsy technique can lead to a misdiagnosis. There are also parts of the prostate where the needle cannot reach so biopsy results can be misleading.” He also points out that because they are done through the rectum, biopsies have a two to three per cent risk of infection. “A handful of men each year die of septicaemia following a biopsy.”
Experts say that thanks to the availability of the PSA blood test, which measures the amount of a protein in the blood produced by prostate cells, there has been a dramatic increase in prostate cancer diagnoses over the past 20 years, with about 35,000 men now diagnosed annually. At present, men with a raised PSA are advised to have a transrectal ultrasound (TRUS) guided biopsy, a painful and invasive procedure, usually done under local anaesthetic, in which a needle is guided
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Traditional biopsies involve inserting a needle though the rectum to obtain samples of prostate tissue. Now, on the eve of a major clinical trial to find the best way of diagnosing the disease, experts say that this method may be leading to over-diagnosis and unnecessary surgery, as well as missing some cancers.
Medical researchers have started recruiting more than 500 men with suspected prostate cancer to take part in a trial to show whether non-invasive MRI scanning can be safely used to reduce the number of men having invasive biopsies. The £3 million government-funded Promis (Prostate MRI Imaging Study) trial will be based at several major cancer centres.
“We’re looking at whether a man can safely avoid a biopsy if his MRI scan proves negative,” says Richard Hindley, a consultant urologist at Basingstoke and North Hampshire hospital who is involved in the trial. “There’s an increased realisation that the traditional biopsy technique can lead to a misdiagnosis. There are also parts of the prostate where the needle cannot reach so biopsy results can be misleading.” He also points out that because they are done through the rectum, biopsies have a two to three per cent risk of infection. “A handful of men each year die of septicaemia following a biopsy.”
Experts say that thanks to the availability of the PSA blood test, which measures the amount of a protein in the blood produced by prostate cells, there has been a dramatic increase in prostate cancer diagnoses over the past 20 years, with about 35,000 men now diagnosed annually. At present, men with a raised PSA are advised to have a transrectal ultrasound (TRUS) guided biopsy, a painful and invasive procedure, usually done under local anaesthetic, in which a needle is guided
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