Leave no guesswork in prostate exam

The article in the July 14 paper on prostate cancer treatment options has an important caveat: it discusses studies where the cancer is confined to the prostate. When men are first diagnosed by a urologist with prostate cancer, this is usually signaled by rising PSA, followed by a biopsy.

Many, if not most, urologists will biopsy only the prostate. They will thus be unable to say whether and where the cancer, if present, has spread outside the prostate. It is thus important for men having a biopsy to ask the question of the doctor, “Are you also going to biopsy surrounding prostate tissue, such as the seminal vesicles?” If the doctor answers no, then a key question will be left unanswered, should the prostate be found to contain cancer.

Should the biopsy show prostate cancer, an alternative is to request an MRI of the prostate and its surrounding tissue to look for signs of cancer. This can also be useful prior to having the initial biopsy in that it can guide the urologist as to where biopsy samples should be taken.

Men should make sure that a determination that their prostate cancer is confined to the prostate is supported by medical evidence rather than guesswork.

This story was originally published July 23, 2017 at 7:18 AM with the headline "Leave no guesswork in prostate exam."