New prostate cancer diagnostic tool comes to region

Dec 30, 2013

Upstate Medical University has a new tool that can help diagnose one of the most common cancers that strikes men. The hospital is one of the first in the nation to purchase a technology that gives doctors a more targeted approach in finding prostate cancer.

Jeff Barkley, a firefighter from Phoenix, had close family members die from prostate cancer. But even as his PSA level rose over the last several years -- that’s the blood test that is an indicator of prostate cancer -- five biopsies came back negative.

"It was a relief each time they were over, especially when each one came back negative," said Barkley. "But yet, I still had a doubt, and there was a suspicion there was, even with my urologist, that something was going on."

And something was going on. But it took a new procedure at SUNY Upstate University Hospital to find the malignant lesion. The procedure fuses pre-biopsy MRI images of the prostate with ultrasound to locate evidence of cancers that are sometimes elusive, according to urologic oncologist Srinivas Vourganti.

“With only ultrasound, you can’t see where the cancer is. But the power of the MRI is it allows you to see the cancer, but it’s difficult to bring in to the office. So this technology is called fusion MRI ultrasound biopsy, and it allows you to get the best of both worlds," said Vourganti.

Along with missed cancers, doctors say this technology can identify indolent cancers, or those that grow so slowly they don’t require immediate treatment, says the university's urology chair, Gennady Braslavsky.

"So much of the controversy about the PSA screening, is not that PSA is that bad of a test, but that this test has led to diagnosis of indolent disease, and the side effects of treatment often are not worth the treatment themselves," said Braslavsky.

Bratlavsky says this technology will be especially useful for men who have continued high P-S-A tests, but negative biopsies.

"Identifying those who have been missed or who would like to proceed with a higher certainty of finding more aggressive cancers, especially if there is a family history of a relative who may have succumbed to prostate cancer.”

Bratslavsky says doctors currently look for cancer using random biopsies after a patient has a high PSA or prostate specific antigen levels.  He says men can have several negative biopsies, before doctors discover the cancer.