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New Screening Detects Aggressiveness of Prostate Cancer

New Screening Detects Aggressiveness of Prostate Cancer

A radiologist examines a patient's X-rays after a cancer prevention medical check-up. | Reuters/Jean-Paul Pelissier

More Americans are presenting signs of high-risk, more invasive types of prostate cancer in the past four years, according to a new study.

According to a report by Dr. Thomas Ahlering of the University of California to European Association of Urology (EAU) 2018 Congress, there has been a noticeable increase in cancers of higher Gleason score, as well as in the median level of prostatic-specific antigen (PSA), in the past years. The results became apparent in the four years since the US Preventive Services Task Force (USPSTF) recommended in 2012 that there was no need to routinely screen asymptomatic patients for early detection of the disease.

In the study created by Ahlering and his colleagues, they monitored nine centers in the U.S. with high-volume referrals and compared patients with prostate cancer of Gleason grade 8 or higher. They discovered that between October 2012 and September 2016, after the USPSTF released the recommendations, there was a significant increase of about 24 percent of diagnoses in the Gleason 8+ group. From 8.4 percent, the incidence of high-grade Gleason 8+ prostate cancers ballooned to 13.5 percent.

According to Ahlering, this only proves that early screening is more important than ever, especially since treatment for high-risk prostate cancer has its limitations.

Meanwhile, a new research posits a type of screening that will be able to better distinguish if the prostate cancer is bound to be aggressive. In the past, tests compromise of checking the prostate-specific antigen (PSA) and histological analysis of biopsy tissue. Scientists from Massachusetts General Hospital advances that the use of magnetic resonance spectroscopy (MRS) will be more effective.

Based on the report, the MRS will generate the patient's metabolomic profile, which will then be used to determine the grade and stage of a tumor, even its risk of recurrence. The metabolites contained on cancer lesions will reportedly aid in the detection of the disease by analyzing the histology of the prostate. The scientists believe that the test would reveal the differences in the metabolic activities of the tumor, even if it was benign. This will help in the recommendation if a patient will need a prostatectomy.

"Prostate cancer detection through elevated PSA levels followed by prostate tissue biopsies often cannot differentiate between patients with early-stage, patients with indolent disease, and patients with aggressive cancers," said Dr. Leo L. Cheng explained. "The additional metabolic information provided by magnetic resonance spectroscopy can help guide treatment strategy, both to prevent overtreatment of slow-growing tumors—a critical and widely recognized current issue—and to identify the aggressive tumors for which additional treatment should be considered," he added.

Meanwhile, a new treatment involving high intensity focused ultrasound is reportedly an effective way to cure prostate cancer. As Dr. Dipen Parekh of the University of Miami School of Medicine explains, the "HIFU" does not involve surgery. It is a procedure that involves the transmission of waves that destroy the cancer without much damage in the organ, just like what happens during operations or radiation therapy. This treatment has reportedly been around since 2015 when the FDA approved its use.

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