Many men do not realize that they have a choice when a physician
recommends a prostate biopsy. Often they sit there in shock when told
that they will need a biopsy. This scenario is played out over a million
times annually though out the United States each year. The fact that
alternative diagnostic procedures are not discussed or even brought to
the patient's attention is amazing. It is important to note that medical
practitioners have relied upon prostate biopsies since the first one
performed in 1930. A lot has changed in eighty years however the
prostate biopsy is still the most relied upon diagnostic procedure.
Today revenue generation from prostate biopsies is estimated at 3
billion dollars annually in the US. If you have ever found yourself
facing a biopsy you may be surprised how most health care providers fail
to discuss the alternatives to a prostate biopsy. In addition no one
ever discusses the fact that men who undergo a prostate biopsy often
experience side effects due to the procedure itself.
Prostate cancer is serious and statistically it is projected that one
in six men will be diagnosed with prostate cancer. Within this group of
men ten percent will have a life threatening or dangerous form of
prostate cancer. Prostate cancer is the second leading cause of death
related to cancer. In 2010, it is estimated that 32,050 men die annually
from prostate cancer in the United States. The most common test for a
prostate cancer screening is a blood test known as the PSA
(prostate-specific antigen) test. This may be in combination with or
without a DRE (digital rectal exam). When the results of these tests
indicate the possibility of cancer it is currently common that medical
professionals will proceed or recommend a prostate biopsy.
A
prostate biopsy is an invasive procedure that involves a series of
needles and puncture wounds to the prostate. Most men fear a biopsy of
the prostate due to the fact that in the event cancer is present
research has discovered that the biopsy increases inflammation and the
progression and spread of cancer. Additionally the biggest risk of this
invasive procedure occurs when the tissue samples, obtained via puncture
of the prostate gland, miss the cancerous tissue. Only 75 percent of
cancers are detected via a patient's initial biopsy. Often this leads to
multiple invasive biopsies generally spaced from 6 weeks to three
months apart. Typical costs associated with a prostate biopsy, include
both a physician fee and a laboratory fee, generally ranging from
$1500.00 to $3200.00. It is not that uncommon to have multiple
successive prostate biopsies. Obviously these biopsies are lucrative for
the medical professional performing the procedure and for the
laboratory processing the tissue samples. Men who elect to proceed with
the biopsy often experience erectile dysfunction and increased urinary
problems. The actual biopsy procedure has been shown to predispose men
to side effects such as difficulty urinating and increased waking due to
nighttime trips to the bathroom. The degree of side effects actually
increases substantially post the biopsy procedure. Only 10% of the men
before the biopsy reported severe side effects. One week after the
biopsy the percent of men reporting severe side effects increased to
18%. By week 12 post the biopsy almost 30% report severe side effects.
In addition to severe side effects, 39% report less severe or moderate
side effects post the biopsy procedure.
Today there is an
alternative diagnostic procedure to an invasive prostate biopsy. Similar
to the traditional Sonogram, also known as ultrasound, which is a
familiar diagnostic test performed on pregnant women due to the fact
that it is safe for the unborn child. The biggest difference is that the
typical sonogram is not in color and the area of administration. A
Power Color Doppler Sonogram (3D CDI-TRUS- 'Three dimensional color
Doppler imaging - trans-rectal ultrasound') can be performed on the
prostate and it is painless, safe, and not surgically invasive. Clinical
literature substantiates that the 3D CDI-TRUS is a diagnostic technique
with excellent sensitivity (0.82) and specificity (0.91) for detecting
prostate cancers, even if PSA levels might not be elevated or are within
the grey zone. [1] This diagnostic technique reduces unnecessary
biopsies in men with elevated PSA levels without violating cancer
detection. The estimated cost of this procedure is about $500. The 3D
CDI-TRUS takes less than an hour to perform and can be performed in your
doctor's office. Recovery from this procedure is instantaneous, so you
may return to work the same day. Generally, 3D CDI-TRUS procedures are
performed by interventional radiologists.
Another alternative
non-invasive evaluation for prostate cancer can be performed with a
standard MRI (Magnetic Resonance Imaging). The MRI's accuracy is 89%.
Despite the fact that an MRI tends to over-stage the tumor; most
physicians feel that an MRI does not provide added information over the
results available from surgically invasive prostate biopsies and PSA
data. [2] Recent development and use of MR Spectroscopic Imaging (MRI-S)
expands the diagnostic assessment of prostate cancer beyond the
traditional information provided by a standard MRI. [3,4,5] This newer
technology MRI-S uses multiple coils to provide a better image of the
prostate and cancerous tumors if present.
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