The adoption of new technology at Overlake Medical Center could make a huge difference in the lives of Eastside men suffering from one of the more common and fatal forms of cancer in the country.
Prostate cancer is the most common cancer in men in the United States, and the second-leading cancer to cause death. It is also, physician note, challenging to diagnose and assess.
“One in seven men will be diagnosed with prostate cancer during his lifetime, but not all prostate cancers require immediate treatment,” said Overlake urologic oncologist Dr. Khanh Pham. “In the past it has been a challenge to distinguish between tumors that are potentially deadly and those that are indolent.”
For many decades, prostate cancer has been diagnosed after blood tests and a digital rectal exam. An elevated level of prostate-specific antigens (PSA) in the blood may indicate prostate cancer, although it may not. An elevated PSA level could mean something as simply as an infection, Overlake’s Medical Imaging director David Winokur said.
Even when a patient is diagnosed, the decision to threat the cancer is not black and white.
In the past, doctors treated all instances of prostate cancer with radiation, chemotherapy and/or surgery, leaving some patients with side effects like incontinence and erectile dysfunction.
The majority of the time, prostate cancer tumors are slow-growing and can just be actively watched by doctors. If selected appropriately, more than 94 percent of men in one study survived without treatment or malignant growth 15 years after their initial diagnosis.
Whether or not to watch the cancer or treat it has generally been decided using a grading system through which the cancer is ranked between six (low-risk) and 10 (high-risk). However, studies show that 30 percent of patients who receive a grade of six actually have a fast-growing, high-risk case of prostate cancer.
That’s where Overlake’s latest methodology comes in.
Overlake Medical Center formally adopted a new standard of case fror prostate cancer last month, integrating a infrequently used piece of technology that doctors say has led to more diagnosis among their patients. They are one of two area hospitals to embrace the technology.
Doctors such as Pham are now using MRI imaging to more accurately detect any tumors and their locations, making for more precise biopsies.
“MRI-guided biopsies are a game changer. We now have the ability to pinpoint exactly where the tumor is and biopsy the precise target,” Winoker said.
While the technology has been around for a decade, it has only seen wide use in the last three or four years. Before Overlake’s adoption, Pham had only seen it used occasionally, he said.
The treatment is not perfect. Twenty percent of prostate cancer cases are missed using the MRI alone, and many hospitals do not employ it in part because of the high cost of the MRI machine.
“I don’t think one will actually replace the other. More likely, they’ll be used in conjunction in the future,” Pham said. “It’s really just helping us be more accurate.”
Although there is not any statistical data to determine how the technology impacts patients at this time, Pham has seen the MRI’s benefits in his patients.
Using the MRI, Pham discovered tumors in one long-term patient at Overlake Hospital who had continuously tested negative. In another case, he found a second, previously undetected and aggressive tumor in one patient whose initial diagnosis was low-risk.
It is generally recommended that men have their blood tested every year or so, according to medical professionals.
“It’s important to be evaluated by someone who knows how to treat prostate cancer appropriately. That’s what we’re doing here [at Overlake],” Pham said.
