Each year there are approximately 28,000 deaths and nearly 242,000 new cases of prostate cancer diagnosed in the United States [Source: National Cancer Institute]. Early detection and treatment are key to survival, especially for aggressive forms of the cancer (which account for one third of all cases) or in slow-growing cases that are symptom free.
Though transrectal ultrasound has been used to guide needle biopsies for several decades, a new higher resolution imaging technology is helping physicians at The Oregon Clinic refine and improve methods for detecting prostate cancer.
According to Lance Marr, MD, board-certified urologist at The Oregon Clinic, “Guided-needle biopsies use an ultrasound probe with a needle channel that guides the needle to the desired area. The advantage of high resolution ultrasound is that you can see where the needle is positioned in the tissue within a millimeter. This new technology lets us very accurately determine the size of prostates and very accurately biopsy those men who need it.”
Performing a guided-needle biopsy using high resolution imaging takes approximately 20 minutes and is usually done under local anesthesia with minimal discomfort. Patients often receive antibiotics after the procedure to prevent infection, which is observed in one to three percent of all patients. Dr. Marr and other physicians are currently trained in the new technology, which is now offered at The Oregon Clinic - Urology, located in the Providence Portland Medical Plaza. They perform about 100 prostate needle biopsies annually in men whose ages range from the mid 50s to early 70s.
The American Cancer Society (ACS) recommends that men at high risk -- African American men and men who have a father, brother or son diagnosed with prostate cancer before the age of 65 -- begin discussions with their doctors about prostate cancer screening at the age of 45. Men at lower risk who are in good health can wait until age 50. For those men who choose to be screened after discussing the pros and cons with their doctors, the ACS recommends a prostate-specific antigen (PSA) blood test accompanied by an optional digital rectal exam. (Complete guidelines can be found at the ACS website.)
An elevated PSA may indicate a prostate tumor and is often followed up by a transrectal biopsy of the prostate. “For men who are at higher risk of prostate cancer, diagnosis can be life saving, and the ultrasound guided-needle biopsy is a very reliable detection method,” explained Dr. Marr. “Fortunately, this technology is getting better and better all the time.”
The high resolution ultrasound technology is also used in non-cancerous patients. “For benign prostate disease – for people having problems urinating -- the size of the prostate determines the type of surgical intervention,” said Dr. Marr. “High-resolution ultrasound sizes the prostate much more accurately, which helps us manage those patients more appropriately.”