Philip J. Buffington, MD
As advances continue to be made in screening and treatment for advanced prostate cancer, urologists maintain an important role in oncology care.
to talk about new screening methods and hormonal therapies being utilized for patients with metastatic prostate cancer.
Urologists in Cancer Care: What is the current screening process for prostate cancer?
Philip J. Buffington
: The hot new topic is fusion with ultrasound looking at high-risk prostate cancer found on an MRI. You fuse with ultrasound so that when we do biopsies, we can target the areas where we think there is high-grade prostate cancer. Fusion of MRI with ultrasound allows urologists to progress from blind, systematic biopsies to biopsies, which are mapped, targeted and tracked.
With an MRI, although it's not very good at low-risk prostate cancer, it’s very good at showing high-risk prostate cancer, especially prostate cancer in the anterior prostate where it is not well-defined with an ultrasound probe. If you have high-risk prostate, or high-risk lesions seen on an MRI, software is available that enhances the ultrasound. Even though you're not seeing cancerous tissue with the ultrasound, the software will guide you to the spot that was abnormal on an MRI. That helps you pass the biopsy needle into that area.
How would you decide which patients to use this technique on?
We do that type of scanning primarily for what we call repeat biopsies. If someone came in with an elevated prostate-specific antigen (PSA) for their initial biopsy, we wouldn’t necessarily conduct an MRI on that person. But if the patient had already had a biopsy done, let's say a year ago, and then the patient’s PSA went up again and I'm worried that maybe we missed the prostate cancer, I could then send you for an MRI first and then do a targeted biopsy of the abnormality on the MRI. That’s one population.
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