MRI -A whole new look at prostate cancer

This is a video presentation, given by DR Ross Schwartzberg MD to other doctors and medical students in Merci Hospital San Diego:

The presentation focusses on the importance of using MRI to detect prostate cancer. The main points in his video presentation are:

The Benefits of using MRI in prostate cancer

  • MRI used as a triage test before proceeding to biopsy, and guiding targeted biopsy, improves the accuracy of prostate cancer assessment and treatment.
  • He shows how MRI can be used to find more aggressive cancers while avoiding biopsy in those at low risk
  • MRI can not only detect the cancer but also assess the aggressiveness of the cancer.

PSA alone proceeding directly to standard random biopsy is not the best way to assess prostate cancer risk

  • We get a historical perspective of prostate cancer screening and treatment.
  • Dr Schwartzberg explains how PSA fits into the historical perspective of prostate cancer screening.
  • He explains that PSA should not be used as an early detection method for prostate cancer
  • Dr Schwartzberg demonstrates that PSA leads to over diagnosis of prostate cancer because it produces 75% false positives. In other words many men who do not have prostate cancer end up having biopsies that they don’t need.

Flaws in current prostate cancer treatment

  • He explains that prostate biopsies without MRI are performed in a systematic but blind manner
  • Schwartzberg explains that tumors cannot be seen with Ultrasound
  • Compared to observation, prostatectomy did not significantly improve overall or cancer specific survival rates over a 12 year period in localised low risk prostate cancer

Prostate cancer for black men

  • Black men are 2.5 times more likely to die from prostate cancer.
  • Therefore men of African descent may want to consider getting an MRI as the first step.

Dr. Patrick C Walsh – a leading thinker on prostate cancer said,  “The discovery that would have the greatest impact on our field would be the development of accurate imaging of the tumor within the prostate”.  MRI is the breakthrough in prostate cancer treatment that DR Walsh was looking for.