 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
|
Tests for Prostate Cancer at LDC:
|
Lexington Medical Society Special Edition, Lexington Herald Leader October 23, 201
Your Partners in Good Health
Prostate cancer: surgery versus observation BY GEORGE PRIVETT, M.D.
The recent reported results of the long-awaited 10-year PIVOT study (Prostate Intervention vs. Observation Trial) comparing radical surgery versus observation for the treatment of low- to medium-risk prostate cancer in men, shows no difference in the outcomes of the two approaches. Some experts feel that these findings will radically change the approach to prostate cancer treatment, particularly for older men with low- to medium-risk disease.
It has long been known that there seems to be two different kinds of prostate cancer. The most common, comprising about 80 percent of cases, seems to be very slow growing or even indolent, and biopsy shows Gleason score of no more than 6 or 7. In the vast majority of these cases, the patient will die of something else.
In the other 20 percent of cases, the cancers have higher Gleason scores and are much more aggressive. These aggressive cancers spread quickly to bones and other places and are very often the direct cause of death in the patient within five years. These cases are mostly treated with hormone manipulation, local radiation and chemotherapy to control metastatic disease. Radical prostate surgery or radiation may not make much difference in the outcome.
The PIVOT study is important to men with low- to medium-risk prostate cancer because radical prostate surgery, or other treatments such as radiation, are all very expensive and all have potential serious side effects in almost all cases — mainly impotence and incontinence. Newer advances such as robotic surgery and targeted radiation have reduced side effects somewhat; however bleeding, blood clots, infections and even rare deaths are also reported.
On the other hand, observation costs nothing and has no side effects. This study should change the way patients and physicians think about prostate cancer treatment and hopefully avoid long years of dealing with the misery of incontinence and impotence for many men.
Men with prostate cancer should consult with a urologist about all the options available for dealing with prostate cancer. •
MRI screening for prostate cancer
By Dr. George Privett
Lexington Herald-Leader Nov 22, 2010
At issue | Oct. 3 Your Health column, "Prostate PSA screenings key to cancer prevention; Test still holds value despite recent studies"
It's no surprise that there's confusion surrounding the prostate-specific antigen (PSA) blood test. Recommendations for when men should have it vary and results are often unclear.
Some doctors encourage yearly screening for men over age 50. Some advise men who are at a higher risk for prostate cancer to begin screening at age 40 or 45. Others caution against routine screening altogether.
There is, however, general agreement that men should be informed about the potential risks and benefits of PSA screening before being tested so they, with the advisement of their primary-care physician, can make an informed decision on what next step(s) to take. For example:
■ When the PSA is normal, 15 percent of men still have cancer.
■ When the PSA is abnormal, only 12 percent of men have prostate cancer.
In 2010, the American Cancer Society estimates 217,730 men in the U.S. will be diagnosed with prostate cancer and 32,050 men will die from it. Adding to the confusion surrounding prostate cancer is that, while one man in six will be diagnosed during his lifetime, many have slow-growing tumors that likely will not lead to death or require invasive treatment.
It is often difficult for urologists and radiation oncologists to determine the extent and expected behavior of this disease and whether deciding to treat the disease will help or possibly cause more worry or side effects.
Advances in diagnostic imaging are taking some of the confusion and worry away in managing this disease. By using modalities such as MRI, physicians have the opportunity to more accurately determine the severity of a prostate cancer and minimize the number of prostate biopsies a patient requires. Estimates have shown that unnecessary biopsies add nearly $2 million in costs to the health care system.
Currently, more than 1.2 million men in the U.S. undergo a prostate biopsy each year, but less than 15 percent come back positive for cancer. Without an optimal visual picture of the prostate and surrounding area, biopsy exams are essentially conducted "blindly."
Even though 12 to 30 samples are taken, lesions can still be missed and oversampling may occur. While imaging the prostate has historically been done with ultrasound, MRI offers clinicians improved image quality of the prostate gland to support better detection and localization of the area(s) of suspicion that will help pinpoint any specific regions of concern. Similar to MRI for breast cancer, prostate MRI provides for more thorough diagnostic assessment.
Similar to the more advanced breast MRI studies, radiologists interpreting prostate MRIs often use advanced image analysis software solutions to assist them in automating time-consuming manual processes. These solutions also provide radiologists with critical image processing and analysis tools for a more confident and efficient interpretation.
Dr. George Privett is medical director of the Lexington Diagnostic Center & OPEN MRI.
Read more: http://www.kentucky.com/2010/11/22/1535541/mri-screening-for-prostate-cancer.html#ixzz1bv3cgcRk
|
Did you know that:
|
|
Watch Dr. Privett’s WKYT interview on prostate MRI: http://www.youtube.com/watch?v=LRBoKy8HHxY |
|
Prostate DCE-MRI at LDC. Dynamic Contrast Enhanced MRI gives First Good Picture of Prostate Cancer. Lexington Diagnostic Center & OPEN MRI has acquired the capability of providing MRI of the prostate to demonstrate the presence and localization or the absence of cancer. This test utilizes an MRI of the pelvis area with and without contrast enhancement using a surface coil and computer assisted diagnosis (CAD). Special MRI protocols and software (VividLook® by iCAD®) provides dynamic contrast enhanced (DCE-MRI) images that measure abnormal blood flow through leaky blood vessels that are present in cancer. Colorized maps indicate areas in the prostate that are suspicious or abnormal. The test takes about 40 minutes and does not require a rectal probe or difficult bowel preparations. Visualizing cancer within the prostate has been difficult because the prostate is small and deep in the body. Power Doppler Ultrasound using a rectal probe may be useful but random biopsies have been the main diagnostic tool. Dynamic Contrast Enhanced (DCE-MRI) images have for the first time provided the ability to highlight and localize prostate cancer. This allows urologists to target specific areas of the prostate for biopsy and increase the chances for finding cancer if is there. In addition DCE-MRI can help in pre-treatment planning and in post-treatment follow up. DCE-MRI will also be useful in patients who are on blood thinners and who cannot have a biopsy. Finally, DCE-MRI gives an MRI picture of the whole pelvis. Therefore pelvic bone metastases and bladder invasion may be detected. Other diagnostic imaging tests used to evaluate prostate cancer at Lexington Diagnostic Center are Prostacint® nuclear scans, nuclear bone scans, PET scans CT scans and chest x-rays. Lexington Diagnostic Center and OPEN MRI is the exclusive provider in the Bluegrass of VividLook® DCE-MRI and Prostacint® nuclear medicine scans. To download a printable brochure about VividLook DCE-MRI click here. For one year update on Prostate MRI in “MD Update” Click here |
|
Blue Color on DCE-MRI indicates normal blood flow and no evidence of prostate cancer. |
|
Red color on DCE-MRI indicates abnormal flow through leaking blood vessels on the right indicating prostate cancer. |
|
Dynamic Contrast Enhanced MRI (DCE) on the left shows abnormal Crescent Shaped Red coding, indicating cancer. MRI of corresponding slice without DCE on the right is unclear. |
|
ProstaScint® Scan for Prostate Cancer This nuclear medicine test uses a radioactive tracer (Indium-111) attached to a prostate specific membrane antigen (PSMA) or Capromab Pendetide. This is injected and attaches itself to the walls of prostate cells and in particular to cancerous prostate cells. The body is then scanned by a nuclear medicine scanner (gamma camera) and a CT scanner. This information is then fused with CT images and can localize prostate cancer that is outside its normal place, such as in lymph nodes and bone. |
|
Example on Left of CT scan of Prostate. Example on Right of Abnormal ProstaScint scan showing abnormal collection of the antigen. |
|
Lexington Diagnostic Center is the Exclusive Provider for:
|
|
For more information about Prostate Cancer can be found at: The AdMeTech Foundation (www.admetech.org) The Men’s Health Network (www.menshealthnetwork.org) Prostate Health Education Network (www.prostatehealthed.org) Prostate Cancer Foundation (www.prostatecancerfoundation.org) UsToo Prostate Cancer Ed. & Support (www.ustoo.org) |
To Pay your bill on line CLICK HERE
|
© Neurodiagnostics Inc., 2001-11 |
