Men with positive prostate cancer blood tests could avoid risky biopsies in the future, thanks to new research.
Urologists at St Vincent’s Prostate Cancer Centre in Sydney have found MRI scans are 97 per cent effective at detecting when patients do not have prostate cancer.
The research published in the Journal of Urology has been labelled a “game-changer”.
Lead investigator Associate Professor Phillip Stricker said the findings were important because many men received false positive results to the prostate cancer blood test, known as the Prostate Specific Antigen (PSA) test.
“There’s been a lot of controversy about PSA testing over the years. This may take a lot of the controversy away,” Dr Stricker said.
“You’ll be able to see what’s real and what’s not real and we won’t find these unnecessary, insignificant cancers, which are the big controversy.”
The St Vincent’s study looked at 150 men over the age of 40 with positive PSA tests. The average age was 62 years old.
They all underwent MRI scans.
Dr Stricker said the results also mean healthy men could avoid the problems associated with biopsies.
“The traditional technique of biopsy can cause infection in about 2 per cent, that can be quite serious, so you avoid that,” Dr Stricker said.
“It’s unnecessary anaesthetic time, it’s an unnecessary waste of resources.”
Currently the only men who can have an MRI scan are those that can afford it.
The Urological Society of Australian and New Zealand is preparing a submission to get Medicare funding for MRIs for prostate checks.
“The cost currently in Australia – because it all has to be paid privately – is in the order of about $500 to $700 per MRI,” chairman Professor Mark Frydenburg said.
“Currently patients are paying for that themselves.”
Dr Stricker, who ran the study, said spending about $600 on an MRI could save the Government in the long run.
“If you’re saving one person a biopsy, you’re probably saving about $3000,” he said.
“So, in fact the cost benefit, if you save half the people unnecessary biopsies is probably going to be in favour of MRIs.”
Further research needed to determine effectiveness of MRIs
MRI scans also help doctors detect very small cancers and take accurate biopsies.
“We could see where it was so we could actually target that area,” Dr Stricker said.
However, the Professor Frydenburg said there was still more work to be done before MRI scans could be offered more routinely to men with an abnormal PSA blood test.
“It does need to be validated by other studies around the world,” he said.
“If there is a mechanism for reducing the number of biopsies, that needs to be looked into.”
For patient Bill Cortese there is no argument.
“The MRI I think is the way to go, I know they are expensive but at the end of the day you can’t put a price on health,” Mr Cortese said.
“I feel more comfortable that they can find the problem and attack it rather than just guessing and exploring the prostate at random.”
Professor Frydenburg said there was still a lot work to be done before the MRI could be offered as a mainstream test.
“It’s also availability of time in an MRI machine magnet. There’s only a limited number of these machines around the country.
“But it’s a very exciting thing to be looking at.”
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