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What is prostate cancer and how is it diagnosed

Prostate cancer is the second most common cancer in men after skin cancer. One in nine men may be affected by it during their lifetime. Prostate cancer has various symptoms depending on its stage and stage of the diagnosis. In some cases early and accurate diagnosis may improve the chances of recovery and allow for a wider range of treatment options. The test is a mapping biopsy of the MRI-conjugated prostate in a transperineal approach.

Examination to diagnose prostate cancer in cases where there is a suspicion for the disease.

The test is performed using a biopsy of the prostate on top of a preliminary MRI scan.

The preliminary MRI examination helps performing a particularly accurate biopsy using ultrasound, and increases the detection odds.

 

In cases where follow-up treatment is needed, read about the Nano-Knife procedure – treatment with electrical energy and the transfer of direct current between thin electrodes (needles) that damage the tumor and its integrity. The operation lasts a little less than an hour and after several hours of recovery the patient is released home.

 

+ What are the advantages and disadvantages of the treatment?

  1. High accuracy due to navigating to suspicious areas which have been pre-mapped on an MRI scan done by the patient. The odds of a diagnosis increase significantly compared to a normal biopsy.
  2. Significant reduction in the risk of infection following the biopsy since the needle does not pass through the rectum.
  3. All the prostate areas can be sampled, thus reducing the need for repeated biopsies.
  4. The test is performed under anesthesia, thus sparing the patient pain and discomfort.
  5. The test completely maps the prostate and the tumor, thus allowing the future treatment to be tailored to the patient.

 

+ How is the biopsy carried out

The biopsy we perform at the Medica – Medical Centers is done during a day surgical hospitalization, under general anesthesia that lasts about 15 minutes. During the test, the prostate is sampled along every 5 mm, and special biopsies are extracted from the suspicious areas. Thanks to a computerized technological coupling that allows real-time MRI scanning and ultrasound examination, a “fused” combined image of the two tests can be seen.

 

+ Why it is better to choose fusion biopsy over regular biopsy

The standard biopsy is more common but has a number of disadvantages:

First of all there are tumors which elude detection because the biopsy is limited to the back of the prostate only. In addition, because the sample is taken through the rectum, the chance of infection is 1:200. Another disadvantage is the painful and unpleasant experience for the patient.

In contrast, fusion biopsy has several advantages:

The biopsy needle passes through the skin (and not through the rectum) so the incidence of infection drops to 1:2000. In addition, the angle of entry of the needle allows reaching all the prostate areas and sampling it in its entirety (including the anterior prostate), and most importantly, due to the fact that it is “fused” to the MRI, the chance of an accurate diagnosis of the cancer increases by 30%. Fusion biopsy is performed under a short general anesthesia, thus sparing the patient discomfort and pain.

Thanks to the fusion biopsy precise mapping, a complete picture of the prostate and the exact location of the various tumors (if discovered) are obtained. If treatment is required, there are options of the focal (local) treatment or surgery for radical resection and planning a high-precision surgery which allows to determine which are the areas requiring extra care and safety margins, and which are the areas that allow approaching the prostate and preserving structures that are vital for urinary control and sexual function.

 

+ How to prepare for the test

The evening before the test: The patient will take a syrup or a pill that encourages bowel movement.

On the day of the test: The patient is asked to be on an 8-hour fast.

On the morning of the test: it is recommended that the patient try to pass the bowel movement. If the patient is taking blood-thinning medication, it should be stopped prior to the procedure (Aspirin and Flavix – a week prior to the biopsy).

Duration of the test: The length of the biopsy is about a quarter of an hour, but it is possible that the anesthesia and recovery process will extend the duration slightly.

After the examination: The patient will be transferred to a short recovery, and after an hour they will be released home with the assistance of an escorting person. It is forbidden to drive for safety reasons.

The patient may notice some blood in the urine in the first few days after the test or blood in the semen (dark color of the semen that can last for several weeks). These effects are normal.

Two weeks after the test we will meet again and discuss the test results and the next steps in treatment if they are necessary.

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