Today, I am delighted to welcome Dr. E. David Crawford, Chairman of the Prostate Conditions Education Council, with a guest post on how a new 3-D imaging procedure is helping patients choose the right prostate cancer treatment option.
New 3-D Image Helps Improve Prostate Cancer Treatment Decision Making
by Dr. E. David Crawford
Guy H., a real estate agent and steer roping enthusiast from Texas, had Transrectal Ultrasound (TRUS) guided needle biopsies to determine if he had prostate cancer. Unfortunately results of the TRUS showed that he did, but the needle samples taken only provide estimates on the tumor’s grade and extent, which is used to classify abnormal cancer cells and how quickly they are likely to grow and spread.
Like many patients, Guy was concerned about choosing a treatment method that was too conservative, risking the future spread of cancer. Yet choosing a method that was too aggressive might have put his health at risk due to possible over-treatment. It is a common problem for men diagnosed with prostate cancer and a fine line that patients and doctors walk as they compare watchful waiting to more invasive options, like radiation or prostatectomy.
Because of the risks associated with radiation or prostatectomy, such as urinary incontinence, impotence and other quality of life issues, Guy wanted to access all of his options. Fortunately new technology is providing higher-quality images of the prostate, helping to improve prostate cancer treatment decisions.
Guy visited the University of Colorado where I was conducting research into a technology that can provide men with a more accurate picture of their prostate cancer diagnosis – the Transperineal 3-D Mapping Biopsy.
After consultation and receiving a 3-D Mapping Biopsy, we were able to determine the extent of Guy’s disease and opted to treat his cancer with a less-invasive alternative to radiation or prostatectomy – cryotherapy, which freezes cancer cells and causes them to die. This very focused treatment is the equivalent of the female lumpectomy. The treatment went well and just three months later Guy’s blood work confirmed that he was cancer free. However, like any treatment for localized prostate cancer, one needs to wait many years to guarantee success.
The 3-D Mapping Biopsy captures 30 to 90 transperineal biopsies at regular intervals along an axis, coupled with corresponding coordinates to provide a 3-D view of the prostate. This allows a focused picture to pinpoint the exact location of the cancer cells and provides a comprehensive view of the cancer’s stage. The development of this technology has opened the door to making more accurate treatment decisions, which are based on the patient’s specific tumor. Further, the procedure is performed on an outpatient basis under general anesthesia, reducing the amount of time that patients need to be out of work.
The 3-D Mapping Biopsy is currently in use at the University of Colorado Cancer Center and other centers in the U.S. As use of this technology spreads, the reduction in under- and over-treatments will likely increase the survival rate of prostate cancer patients overall and mark a monumental turning point for the prostate cancer community.
About the Author
Dr. E. David Crawford is the distinguished Professor of Surgery, Urology, and Radiation oncology, the Head of the Section of Urologic Oncology at the University of Colorado Anschutz Medical Campus, Chairman of the Prostate Conditions Education Council and founder of Bingham International Center for the 3D Diagnosis and Treatment of Prostate Cancer. You can learn more about him on this page. For more information about the Prostate Conditions Education Council, visit www.ProstateConditions.org or call 866.4PROST8.
1. Tumor Grade (2004). Retrieved August 17, 2011, from http://www.cancer.gov/cancertopics/factsheet/detection/tumor-grade
2. Barqawi A.B., Rove K.O., Gholizadeh S., et al (2010). The Role of 3-Dimensional Mapping Biopsy in Decision Making for Treatment of Apparent Early-Stage Prostate Cancer. University of Colorado Denver,
3.Garnick M.B., Abrahamsson P.A., DeWolf W.C., et al (2011). 2011 Annual Report on Prostate Diseases. Harvard Health Publications, 94.
4. Cryotherapy for prostate cancer (2001). Retrieved August 17, 2011, from http://www.mayoclinic.com/health/cryotherapy-for-prostate-cancer/MY01634
5. Garnick M.B., Abrahamsson P.A., DeWolf W.C., et al (2011). 2011 Annual Report on Prostate Diseases. Harvard Health Publications, 94.