Fusion biopsy finds prostate cancer early

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When prostate cancer is found early, the five-year survival rate is almost 100%. But when it goes undiagnosed and spreads, that percentage plummets to 30%.

We look at fusion biopsy, a cutting-edge technology combination that is the key to finding prostate cancer early so treatment can begin.

Ray Sousis is an engineer and car collector. When his prostate-specific antigen – or PSA, a blood marker for prostate cancer – suddenly went up, Sousis was forced to slow down and confront the fact that he had prostate cancer.

"There's no way a normal biopsy would've gotten a positive on the cancer because it was nowhere near where it would have looked. So, yeah, the fusion biopsy pinpointed exactly where it was," Sousis said.

Fusion biopsy is a new tool to pinpoint suspicious areas using ultrasound and MRI technology. Sousis' tumor was in the upper prostate, an area frequently missed by traditional random biopsy.

"The software, what it does is it takes those images from the MRI and it starts comparing it to images on the ultrasound," urologic oncologist Dr. Naveen Kella explained. "Then when we move the ultrasound probe, it knows exactly where it correlates on the MRI."

Kella performed robotic surgery to remove the diseased tissue.

"I didn't want the conventional," Sousis said. "I don't mind taking risks and going with something new, especially if it's going to save my life."

Each year, 700,000 men with high PSA levels undergo repeat biopsies. Although fusion biopsies are not available everywhere, it is worth asking your doctor about the procedure, especially if the risk in your family is high for prostate cancer.

MEDICAL BREAKTHROUGHS
RESEARCH SUMMARY
TOPIC: FUSION BIOPSY FINDS PROSTATE CANCER EARLY
REPORT: MB #4701

BACKGROUND: Prostate cancer occurs in the small walnut-shaped gland that produces the seminal fluid, which nourishes and transports sperm. It is one of the most common types of cancer in men, usually growing slowly and initially confined to the prostate gland, where it may not cause serious harm. Some kinds may grow slow, needing minimal or even no treatment. However, some forms of prostate cancer are aggressive and can spread quickly and cause more damage. Signs and symptoms may not show in the early stages, but advanced prostate cancer may cause trouble with urination, blood in semen, discomfort of the pelvic area, bone pain, erectile dysfunction, and a decreased force in the urine stream. It is not clear what causes prostate cancer, but it occurs when cells in the gland become abnormal and mutate; growing and dividing more rapidly than normal cells do. (Source: https://www.mayoclinic.org/diseases-conditions/prostate-cancer/symptoms-causes/syc-20353087)

DIAGNOSING: There are two tests commonly used to screen for prostate cancer. The first is a digital rectal examination or DRE, when the doctor will feel the surface of the prostate through the bowel wall for any irregularities. Second, a PSA blood test can be taken. There is controversy surrounding the PSA test in men with no symptoms of the disease, because while it is useful in detecting early-stage prostate cancer in men with many risk factors; PSA screenings find conditions that are not cancer, such as BPH in addition to very-slow-growing prostate cancers that would never threaten a man's life. This may cause urgency in surgery and other treatments, which may not be needed, and can cause serious side effects and affect a man's quality of life. An ultrasound can also be ordered to further evaluate the prostate and look for areas that may be cancer, and has been used in the office for years. (Source: https://www.cancer.net/cancer-types/prostate-cancer/screening)

MRI'S IN COMBINATION WITH ULTRASOUND: While the ultrasound can show areas that may or may not be cancer, it alone cannot accurately predict and find the prostate cancer. However, thanks to MRI images, it is possible for your doctor to get a better quality image and help identify any chance of cancer. A patient can get a fusion, where all information from the MRI is collected and the ultrasound is used to detect the cancer in the doctor's office, then an in-office biopsy can be performed to verify that there is cancer. "When the patient undergoes a fusion biopsy, the software takes those images from the MRI and it starts comparing it to images on the ultrasound, and we can create images that match. Once we have enough images that match, then when we move the ultrasound probe it knows exactly where it correlates on the MRI so it's like a heads-up display. You're then able to move around with an ultrasound in the office, but you're seeing it moving around like if you're looking at the MRI; in much higher resolution with much better images." (Source: Naveen Kella, MD)