The mighty MRI proves it could potentially save your life yet again! In Britain, prostate cancer is the most common form of cancer in men. If high levels of serum prostate specific antigen (PSA) are detected in the bloodstream, men will usually undergo transrectal ultrasound-guided prostate biopsy (TRUS-biopsy). This involves twelve needles which take random samples from the whole prostate which can then be tested. Although not obvious at first, this technique has some very clear flaws and limitations. For instance, it can miss the cancer that is there as not the entire prostate is tested, and even if a fragment of the cancerous tissue is extracted, the biopsy may fail to spot whether it is in any way, shape or form aggressive. Including this, the TRUS-biopsy can cause side-effects including bleeding, pain, and infection. So overall, this biopsy is blind to the location of cancer in the prostate, leading to many men without clinically important cancers undergoing unnecessary biopsy, over diagnosis of clinically unimportant disease, and under-diagnosis of clinically important cancers.
Therefore, to see whether there are other methods that can reduce the performance of unnecessary biopsies and improve diagnostic accuracy, a trial was performed in 11 hospitals in the UK. This trial involved the use of a multi-parametric MRI on men with high PSA levels, to see whether this device, having been around for some time, can produce some positive outcomes- and they were amazing. 93% of aggressive cancers were detected by using the MRI scan compared with just 48% when the biopsy was done at random. The MR-MRI produced the most precise and intricate images, providing information on tissue anatomy, as well as valuable data on tissue characteristics such as prostate volume, cellularity, and vascularity. There is also some more evidence that suggests this MRI can detect higher-risk disease and overlook low-risk disease.
Having said that, after performing a MR-MRI on a patient, a biopsy afterwards may still be required for further testing, but this time with much much more accuracy because the exact location and characteristics of the cancerous tissue has been established.
With every new advancement in technology, there will always be that small obstacle stopping the idea from getting incorporated into the system… so despite this new revolutionary study, performing a MR-MRI on every patient may put some strain on the NHS in terms of cost and funding…
Each scan costs between £350 and £450 per patient. Thinking about it, if all patients across the UK with high levels of serum prostate specific antigen were to receive a MR-MRI scan, the NHS would receive a bill of around £40m through their letter box. Now, this is not such happy news for the NHS taking into consideration the current state and the complications it is experiencing with strikes and the already-struggle with cost and funding. BUT, weigh the cost of this scan with a biopsy, and the figure is pretty much the same so will it really make that much of a difference? I’ll let the board decide that, however I know that:
- Catching aggressive cancers earlier not only can potentially save the patient but also deliver savings, as patients with very low-risk cancers will not be receiving unnecessary ‘heavy’ and distressing treatments.
- This new leap in diagnosing prostate cancer should not & will not be limited to just diagnosing and treating prostate cancer. Prof Ros Eeles, from the institute of Cancer Research in London, said this “study and data was very important” and scientists are already working at linking and making connections to try adapt this new idea to other forms of cancer as well as other diseases, and develop more efficient diagnostics. Therefore, this may be very beneficial in the long-term.
So far, I have produced a few of my very own posts on this blog about some events that have happened this year, and I am truly surprised by the topics I have written about (this being a good surprise). It is because before beginning, I thought “yeah, I will just be writing about different diseases each week”. However, I am also writing about current affairs that broaden my own perspective and open my eyes to the world of medicine more and more throughout every post. In a way, I am not only giving you a message but also learning something about myself as well as learning a complete different dimension of medicine. I treat every bit of research into every post like a mini step towards med school, so although not directly, you are actually experiencing my journey to University-which is why I am writing this blog- It is increasing my passion for medicine and resilience every single day!