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As most of you know there is an overtreatment problem associated with PSA screening and a controversy about what to do about it. One of the options is to stop routine PSA screening, but there are other possible solutions.
The European Randomized Study of Screening for Prostate Cancer (ERSPC) in their 13 year update reported that PSA screening can save lives. However, they couldn't yet recommend it for population screening like we do here in the US because of the overtreatment problem. They suggest that perhaps, in the future, a multiparametric MRI before the biopsy might be able to reduce the level of over-treatment enough to make PSA screening unequivocally worth doing.
I thought I would write up a short description of what exactly multiparametric MRI is and how it works with some references. I'm going to make this available to as many people as possible. MultiParametric MRI and the PSA test
You're the first person I've come across who has mentioned the use of MRI FIRST to accurately diagnose PCa and what stage it is at.
And yes, it would prevent many cases of unnecessary treatment,
I have thought that was a logical, practical idea for many years now.
I wish I could have had an MRI immediately they found my PSA was 182 back in 2005.
It would have saved an invasive cystsopy under general anaesthetic and a week of pure hell in a hospital ward after the procedure.
Everything that could have gone wrong DID go wrong.
I would have been so much better off with an MRI, which would have spotted the T4 tumor and spread instantly.
In my case, I had an MRI a few weeks after I came out of the 'hell ward' in the urology department, which did give the clear picture.
Many thanks for writing up such an excellent article and the link to it.
Re: MultiParametric MRI and \"saving\" the PSA test
They want to cut down on both the number of unnecessary surgeries and all the biopsies. They calculate that they need to treat approximately 25 men with surgery or radiation to reduce a single prostate cancer death. If you figure that 80% of the biopsies are negative that means 100 biopsies and 25 prostatectomies are needed to reduce one prostate cancer death. If there weren't any complications from the biopsies and treatments, it wouldn't matter. but more than a few go quite wrong.
