It is important for men to reflect on their lifestyle and health choices, and perhaps even to consider a medical screening. Among the many health-related issues that concern men, prostate cancer remains a common topic of discussion.
Prostate cancer is a leading cancer affecting 1 in 6 men in the United States.
However, recent technological advances are changing the playing field for men undergoing prostate cancer screening as well as for those under treatment.
While traditionally, men over the age of 50 have been encouraged to undergo prostate screening with a simple blood test (PSA test) and a prostat
e exam, due to increasing diagnoses of men in their 40s, doctors are now prompting men over the age of 40 to get screened. Moreover, the development of new prostate MRI imaging has increased screening accuracy, proving to be an essential tool for men at risk of prostate cancer. Through the use of special sequences, prostate multiparametric MRIs detect and display cancers with high accuracy, changing the way men at risk of the disease are being evaluated and treated.
In the past, men with elevated PSA levels or abnormal prostate exams underwent ultrasound-guided prostate biopsies to determine if any cancer was present in the prostate. However, as most prostate cancers are not visible on ultrasound evaluations, most ultrasound prostate biopsies are essentially blind, random, and inexact. With the new prostate MRI technology, men are better assessed to determine if they need a biopsy at all. For those men whose scans reveal suspicious lesions, the MRI can clearly show their location and extent, allowing the prostate cancer specialist to locate specific targets for a special biopsy referred to as an “MRI Fusion Prostate Biopsy”, which are much more exact than standard ultrasound biopsies.
Clear visibility of the cancers provides a distinct added advantage: it allows prostate cancer specialists to perform focal therapy, or a ‘prostate lumpectomy’, where much of the prostate tissue is preserved. Decades ago, if a woman was diagnosed with breast cancer, the entire breast tissue was removed to ensure the cancer was eradicated. Due to better imaging and localization of breast cancers, most women no longer need to remove their entire breast, but can remove only the cancerous parts while preserving healthy tissue in a ‘breast lumpectomy’. Until recently, inability to identify the exact location and extent of prostate cancer meant that specialists recommended the removal or radiation of the entire prostate to ensure adequate treatment; yet potential side effects of such over-treating through prostate surgery or prostate radiation include erectile dysfunction and loss of urinary control. Overtreatment of the prostate caused by the lack of both proper imaging and effective and safe focal treatment is now no longer an issue.
As mentioned, MRI fusion biopsies effectively reveal the location and extent of prostate cancers in men. Once it is localized, how can we precisely treat it? The answer for many lies in HIFU, or High Intensity Focused Ultrasound, an exciting new treatment approach that is revolutionizing the treatment of prostate cancer. HIFU is a non-surgical treatment modality that uses harmless ultrasound waves with pinpoint accuracy to destroy cancerous tissue.
Given it’s precision, the normal prostatic tissue and the vital structures aroundthe prostate—such as the nerves that control erections and the muscles that provide urinary control—can be preserved. Thus, HIFU is an outpatient procedure that takes around 1-3 hours to perform and typically has no down time. In experienced hands, HIFU procedures can preserve normal erectile function and urinary control while effectively eradicating the prostate cancer.
Nevertheless, while such advances have been made in optimizing screening and treatment options for prostate cancer, we strongly encourage men to look into prostate cancer prevention, including dietary modifications and lifestyle changes that lower risk of developing the disease.
Dr. Kia Michel is founding member of the prestigious Comprehensive Urology Medical Group and the founder of the Prostate Cancer Specialists of Los Angeles, an organization comprised of leading prostate cancer specialists dedicated to helping men with prostate cancer or at risk of developing prostate cancer. Visit www.lapeerhealth.com. Article was originally published on July 4th, 2016 by Malibu Chronicle