Prostate cancer screening advances locally
The Trend
By Megan Doherty
Hearing that a machine can do part of your job — and do it better than you — might put fear in the hearts of many men and women. But, that fearful outlook changes entirely when your job includes detecting and diagnosing cancer. Any machine that assists doctors, like Langhorne Urologist Dr. Peter Sinaiko, in getting an early cancer diagnosis is hailed as an advance.
Sinaiko is employing a new technology, TargetScan, that assists doctors in prostate biopsies. Prostate biopsies are the only way to confirm the presence of prostate caner.
"Originally, the prostate biopsies were done rather blindly," said Sinaiko.
He explained that, in the past, during a prostate biopsy, he would take several tissue samples as he was guided by ultrasound imaging. The doctor would choose which parts of the prostate the tissue samples would come from.
The new technology remedies the 'blind' biopsies through 3-D imaging. Information gathered by the probe is used to create a computerized 3-D model of the prostate. Then, the computer creates a map, including different sections and depths, of where to collect tissue samples.
"It tells you where to biopsy, so you do a representative biopsy of the prostate," said Sinaiko.
Prostate cancer does not typically grow as one tumor, but rather as several small tumors, according to information on The Prostate Cancer Foundation's Web site (www.prostatecancerfoundation.org).
Sinaiko said the rate of positive biopsies has jumped from about 25 to 35 percent before TargetScan to about 50 percent after.
"So, we might have missed some before," said Sinaiko.
The use of TargetScan is still relatively new. Sinaiko acquired his machine last year, and believes his was 10th in the United States and that, nationally, about 25 practices now use TargetScan for prostate biopsies.
The past three decades have brought about a lot of change in the detection and treatment of prostate cancer. Sinaiko said that, before 1980, the only way to detect prostate cancer was a digital rectal exam, and even then doctors could only evaluate the part of the prostate next to the rectum.
"That's why we so rarely found prostate cancer that was curable," Sinaiko said.
In the 1980s, doctors began to use a PSA blood test as a screening tool. Now, a digital rectal exam and a blood test are used as the initial screening for prostate cancer.
The blood test measures PSA levels, a hormone secreted in small doses by a healthy prostate. Rising PSA levels often lead to a biopsy, said Sinaiko. PSA levels are important because, "Prostate cancer, in its curable stage, has no symptoms," added the doctor.
When confined to the prostate, cancer can be curable. I the cancer has spread, the disease is treatable, but not curable. Early detection is the key to catching prostate cancer before it can spread.
"Over the past 20 years, we [doctors] have become more adept at doing early detection," said Sinaiko.
Sinaiko said African American men, who have a higher tendency to develop prostate cancer, and men with a family history of prostate cancer should begin screening tests at age 40.
"There is a definite familial tendency in prostate cancer," he added.
All other men, he recommended, should start having a PSA test and a digital exam at age 50.
Sinaiko stressed that men should not put off these screening test when the time comes.
"There is an old wives' tale or myth that prostate cancer is a slow-growing cancer," said Sinaiko.
That's not true - prostate cancer has, "a good chance of being lethal," especially when in advanced stages. According to The Prostate Cancer Foundation's Web site, when caught early, prostate cancer has over a 90 percent cure rate. The Web site also says prostate cancer is the most common non-skin cancer in the United States.
Treatments for prostate cancer include surgery, radiation, hormone therapy and other methods.
For more information on prostate cancer detection and treatment, visit www.prostatecancerfoundation.org or call the National Cancer Institute's Information Services at 1-800-4-Cancer.
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