By Raja S. Cheruvu, M.D.
Other than lung cancer, prostate cancer is the most common cancer in American men. The American Cancer Society estimates 180,890 new cases and 26,120 deaths from prostate cancer each year. Fortunately, screening and early detection of prostate cancer is saving lives. Today, more than 2.9 million men say that they are prostate cancer survivors.
The first step in the screening process begins with a man’s visit to his primary care provider, who may find an elevated PSA level on routine blood work. He is then generally referred to a urologist who performs a trans-rectal ultrasound (TRUS) procedure. The TRUS procedure involves taking 12-18 random samples from the prostate gland, which are then sent to a pathologist. The results may come back negative, but there is also a possibility that the blind random sample missed an area of concern. The patient and his doctor then go through a ‘watchful waiting’ period until the next PSA level is taken. If the next PSA level is still elevated or rising, another TRUS biopsy may be performed. This cycle may be repeated several times. Unfortunately, many men are reluctant to undergo this screening, fearing possible adverse effects, including pain and discomfort.
Still, men need to understand that screening is extremely important, as prostate cancer has a greater occurrence (one in six lifetime risk) than breast cancer has in women (one in eight lifetime risk). Also, despite the fact that men aren’t always alerted to signs of prostate cancer, those who do notice symptoms should contact their doctor immediately. These include a need to urinate frequently, especially at night; difficulty starting urination or holding back urine; weak or interrupted flow of urine; painful or burning urination; difficulty having an erection; painful ejaculation; and blood in urine or semen.
Patients need to be aware that the TRUS procedure is no longer the only screening option available. 3T MRI is a more sensitive, non-invasive, painless, targeted screening method for diagnosing prostate cancer earlier and more accurately than conventional ultrasound guided tests. Prostate MRI is truly a game changer.
Its high resolution images allow radiologists to better visualize the prostate gland and determine
if a biopsy is needed. Windsong Radiology Group is the first to offer this technology locally, which is essentially the male version of the mammogram offering increased sensitivity and improved accuracy in localizing prostate cancer. 3T MRI is appropriate for patients with an elevated or rising PSA level, as well as those who have had benign TRUS biopsies.
About the Author: Raja S. Cheruvu, M.D. is a board certified radiologist at Windsong radiology
Group who specializes in cross-sectional imaging and prostate MRI. For more information or to
make an appointment, call 716-631-2500 or visit www.windsongradiology.com.