If you are a male over 40 years old, you may be a candidate for prostate cancer exam. And after you hit 50, regularly scheduled appointments should be on your to-do list. When you meet with your doctor for your annual physical examination, ask about the methods available, including fusion-guided biopsy.

Prostate Cancer Cells
Prostate cancer cells are difficult to detect no matter which method of detection is used. For the past 30 years, doctors had two options for diagnosing prostate cancer: a digital rectal exam (DRE) and/or the prostate-specific antigen (PSA) blood test. A positive reading for either test suggests that there may be a cancer that would require further analysis via an invasive biopsy. Emphasis on the word “may” because these methods cannot detect whether or not the cancer is aggressive and life threatening, or slow growing and not life threatening. If the technique detects a cancer tumor, then the next step is a biopsy to confirm the type of cancer.


Ultrasound Technology to Diagnose Prostate Cancer
To obtain prostate tissue for cancer testing, a series of needles are inserted into different areas of the gland, guided by ultrasound technology, a method that has been used since the 1980s. The ultrasound images help place the needles properly, but the pictures aren’t distinct enough to be able to tell cancerous from normal prostate tissue, making it difficult to target and hone in on suspicious areas for biopsy.

It’s a scattershot “blind” approach, hoping that, if a tumor is present, one of the needles will encounter it. These random biopsies can miss some harmful tumors, while turning up others that are inconsequential and may end up being treated unnecessarily.


Fusion-Guided Biopsy
An MRI scan is better than ultrasound at revealing details in soft tissue, such as the prostate gland, assisting in the diagnosis of prostate cancer in that an MRI image can identify suspicious areas that warrant closer examination with a needle biopsy. But, MRI chambers are not ideal for conducting a biopsy procedure.

The solution? The new fusion-guided biopsy method.

Fusion-guided biopsy, which most health insurance plans cover, is a more effective method in the arsenal of cancer-fighting tools. It is better than the existing approach at finding prostate tumors that need to be treated, while overlooking those that don’t.


The Process
Researchers have developed software that “fuses” those detailed MRI scans with live, real-time ultrasound images of the prostate. A patient first undergoes the MRI scan, and then a radiologist reviews it and marks suspicious areas.

Later, in an outpatient setting, an ultrasound probe is inserted into the patient’s rectum. As the probe moves around the prostate, the fusion software shifts the overlaid MRI image accordingly, providing a detailed 3-D ultrasound/MRI view. The fused image can be used to guide the biopsy needles precisely to the lesion for the sample rather than poking around and hoping to find something. It’s like using a GPS to reach your destination rather than driving without directions.
 

Better Information With Fusion-Guided Biopsy
Each year in the United States, about 700,000 men with worrisome PSA levels undergo repeat prostate biopsies. The fusion-guided biopsy approach should help reduce that number, by giving better information the first time around.

It’s worth a discussion with your doctor. You may also call us at Urology Experts with offices in Bonita Springs, Fort Myers and Cape Coral at (239) 226-2727 to set up an appointment.