Catching prostate cancer sooner

Doctors using MRI for a more accurate test

ST. LOUIS, Mo. – When Bob Washington can't make it to the nearby golf course, his backyard will do. Bob enjoys the little things even more now after beating prostate cancer, a disease that runs in his family.

"Five boys. All of us were diagnosed with prostate cancer," he said.

Washington's PSA levels started to climb several years ago, and a biopsy indicated cancer. Experts acknowledge the PSA is not foolproof nor is a standard prostate biopsy using ultrasound.

"It's a little random whether or not they're actually going to hit upon cancer," explained Kathryn Fowler, MD, Radiologist at Washington University in St. Louis School of Medicine.

Gerald Andriole, MD, Chief of Urologic Surgery at the Washington University in St. Louis School of Medicine is studying the use of biopsies using patients' MRI scans to visualize and target suspicious areas.

"We would get much more valid information about the size, the shape, the aggressiveness and the location of the cancer," said Andriole.

Research shows the MRI targeted biopsy is two and a half times more likely to detect cancer than a traditional biopsy.

Andriole explained, "For certain parts of the prostate, the odds of the ratio go up to over eight fold." 

Washington and his wife have adult twin boys, both of whom were recently married. Bob is vocal with both about regular cancer screenings.

"They've all had their PSA taken, they have a baseline number and I stay on them every year to make sure they continue to go with this," he said.

Andriole says as MRI technology improves, prostate cancer screening may eventually be like mammography screenings for breast cancer. Men with elevated PSA will get an MRI with a follow up biopsy only if the MRI shows an abnormality.

Additional Information:

Second only to skin cancer, prostate cancer is the most common cancer among men in America. The American Cancer Society estimates about 233,000 new cases of prostate cancer and about 29,480 men will die of prostate cancer this year. The prostate is a small walnut shaped gland that is found only in males. Located in front of the rectum and below the bladder, the prostate's main function is to make the fluid that protects and nourishes sperm cells in semen. Prostate cancer develops from the gland cells that are located within the prostate. Because this type of cancer is known to grow slowly, most men never know they have it. Many factors can increase your risk of prostate cancer which include older age, ethnicity: (black men have a greater risk of prostate cancer), family history of prostate or breast cancers, and obesity. Although the cancer is common and can be deadly, it is also seen to be very treatable. More than two-million men in the U.S. are able to count themselves as prostate cancer survivors.

SIGNS AND SYMPTOMS: Some prostate cancers can grow and spread very quickly but most grow slowly and show no signs. Many forms of prostate cancer don't affect most men during their lives and in many cases their doctors don't even know they have it. Once the cancer is advanced, there can be these symptoms.

  • Problems passing urine
  • Blood in the urine and semen
  • Trouble getting an erection
  • Pain in the hips, back (spine), chest (ribs), bones, or other areas
  • Weakness or numbness in the legs or feet, or even loss of bladder or bowel control


NEW TECHNOLOGY:  Doctors have found a more accurate way to pinpoint prostate cancer in men. Instead of using a traditional biopsy, an MRI biopsy allows doctors to identify the areas that are at the highest risk for cancer. The MRI biopsy is allowing doctors to improve accuracy, identify larger tumors and make sure they are sampling the areas of the highest concern. Kathryn Fowler, MD, of the Washington University School of Medicine in St. Louis says, "We hope that this will help us to identify the patients in which the cancer really matters and the patients that will be impacted by tumors. That way, we can potentially avoid over-treating those very low grade or early stage cancers, but really focus our energy and not miss out on the opportunity to treat the patients with a high risk tumor."
(Source: Kathryn Fowler, MD)