Fine tuning the PSA sledgehammer

San Diego Dan has posted a link to an interesting article on various approaches to refining the PSA test. As I said a while ago a raised PSA really only shouts “Have more tests” since it is possible to have prostate cancer with a PSA of zero and to not have it with a PSA of 4,000. Factors such as how much time you spend on the saddle of a bicycle will have an impact on your PSA level. Then there is the question of whether the cancer is aggressive or not. If you can tell this then a lot of unnecessary treatment can be avoided. While I wouldn’t say avoid hospitals and treatment at all costs (and in the US personal costs can be significant) certainly if unnecessary treatments can be avoided not only does it save money it also avoids all the various side effects and risks associated with any medical intervention. The article explains that researchers are developing genetic tests, imaging tests, and algorithms in an effort to reduce the more than a million men a year who have prostate biopsies and, even more important, reduce the thousands who get treatment they don’t need.

https://www.statnews.com/2017/05/04/prostate-cancer-research-psa/

 

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MRI a better route to identify PC

In my last post I mentioned a Radio 4 programme which discussed the grey areas in the diagnosis and treatment of prostate cancer. It also argued for MRI scans before prostate biopsies so that they could be targeted better. Since then a major breakthrough has been published in The Lancet and reported in the press – the BBC called it a ‘Huge leap‘. (The Lancet report is a bit technical for me, but I could understand the BBC report. I had an MRI before my biopsy.)

It appears that an MRI scan  is twice as likely to identify the presence of dangerous tumours as an invasive biopsy and that it identifies  93% of aggressive cancers, compared to 48% identified by a biopsy. It also means that the need for biopsies for men with suspected prostate cancer could be reduced by a quarter (no need to say “Ow”).

This is the second breakthrough in recent months – trials  have shown that a drug activated by laser light successfully destroys early prostate cancer while avoiding side-effects that commonly occur with surgery.