13. All prostate cancers need to be surgically removed:
There are many treatment options to address prostate cancer and not all patients are treated with surgery. The survival benefits from HIFU, cryoablation, radiation and surgery are similar, and physicians evaluate numerous factors before making any recommendations. Surgery may be the fastest way to resect the tumor, but it is also associated with decreased quality of life due to side effects such as incontinence, impotence, shortened penis and positive margins.
14. Prostate cancer recurrence is always treated with long-term androgen deprivation therapy (ADT):
When a patient is treated for prostate cancer with radiation therapy or other therapies and the cancer returns, there are numerous treatment options. It’s a myth that the only effective method is long-term ADT. “A rising PSA after any definitive treatment option for localized prostate cancer demands a prostate biopsy to detect a possible recurrence. Depending upon the man’s age and co-morbidities, he may be considered for a minimally invasive treatment option such as HIFU or cryo to treat a localized prostate cancer recurrence rather than being placed on long-term ADT and the associated problems of metabolic syndrome and bone thinning.”
15. Cure rates from different treatment options are easily comparable:
It’s common for patients to search the internet for cure rates associated with different treatment options. However, these cannot be compared without further information. The comparison may be misleading since few studies include independently validated prostate pathology, patients have different characteristics, and both technology and treatments are constantly evolving.
Learn more about six therapies and treatment options for prostate cancer.
Prostate Cancer News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
“total PSA only may not be cost effective, evaluation of individual men with the PSA as well as the %free PSA may be”
May be but no one knows yet.
So it’s still the same as PSA screening in general. No-one has ever shown that PSA screening, or even PSA screening of a chosen risk group, leads to an overall saving of lives.
It’s about time someone showed that PSA screening of any risk group at all leads to an overall saving of lives.
Regarding your statement:
“An imaging study including an MRI, CAT scan, or ultrasound is not used to diagnose prostate cancer. They may be requested by the physician to evaluate the presence of suspicious areas to be targeted during a biopsy or to evaluate the extent of the cancer. However, it’s a myth that an MRI can substitute a prostate biopsy.”
I would take major exception with your statement. Imaging before biopsy should become standard of care, the same as it is for women suspected of having breast cancer. What woman do you know who would submit to having 150 needles stuck in her breast to see if maybe they hit something and then go get a mammogram to see if they see something? Urologists have this entirely backwards. Random TRUS biopsies should be relegated to some dark closet of the past. TRUS biopsies regularly miss 40% of clinically significant cancer. Modern mp MRI scans have both a negative and positive predictive value of over 90% for prostate cancer. When a man is suspected of having prostate cancer the first step should be an mp MRI scan. If an area suspicious for clinically significant cancer is found, then an MRI guided biopsy targeting the suspicious area is warranted.
Standard TRUS biopsies regularly cause swelling and inflammation in the prostate which often results in a rise in PSA leading to more unnecessary biopsies. Erectile Dysfunction as a result of biopsy is not uncommon. The infection rate of TRUS biopsies is up to 4.5% and often results in hospitalization.
While a biopsy is the only way to diagnose prostate cancer, it should be a targeted, MRI guided or MRI/US fusion guided biopsy, not a TRUS biopsy.