Urologists at the Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine are on the forefront of national studies and technology in the early detection and treatment of prostate cancer.
Prostate cancer strikes one out of every six men, making it the most common non-skin cancer affecting American men. Fortunately, when caught early, the five-year survival rate for these men is nearly 100 percent, according to the American Cancer Society.
Screening for prostate cancer generally includes two tests: a prostate-specific antigen (PSA) blood test and a digital rectal exam (DRE). In the past, urologists used only the amount of PSA in the blood to diagnose prostate cancer. However, thanks to a recent change in the way PSA blood tests are interpreted, urologists at the Siteman Cancer Center are able to diagnose the disease earlier.
Advances in Screening
"Previously, physicians often waited to perform a biopsy for prostate cancer until PSA testing indicated a level of 2.5 nanograms per milliliter (ng/mL) or higher,"says Gerald Andriole, MD, urologist at the Siteman Cancer Center. "Now, urologists at Siteman also use PSA velocity, or rate of change, as an important indicator of the disease."
Urologists use PSA velocity to determine how aggressively the cancer should be treated. Researchers testing PSA velocity as an indicator for cancer found men whose PSA had risen by more than two points from the previous year were at higher risk of death in the next seven years than men whose PSA increased at a slower rate.
In addition, the Siteman Cancer Center participated in studies that determined men with a high PSA velocity were more likely to have advanced forms of the disease.
"If a man's PSA level rises by more than .8ng/mL a year, even though his total value may be less than 2.5 ng/mL, that may mean cancer is present and a biopsy needs to be performed," says Dr. Andriole, "and smaller increases in PSA are worrisome for young men."
Technology Helps Patients, Aids Diagnoses
Once it is determined a biopsy is necessary, physicians use the latest methods to increase the chance of recovery and prevent complications for the patient.
Siteman Cancer Center urologists use the TargetScan system for biopsies and to offer precision treatments for prostate cancer patients. The system uses state-of-the-art technology and fixed positioning to make a 3-dimensional scan of the prostate gland.
"Current technology requires the physician to use a probe with one hand while taking a biopsy with the other, a method that potentially overlooks 20 to 30 percent of possible cancers," says Dr. Andriole. "in contrast, the TargetScan system can better target the cancer site, allowing for more precise biopsies and treatment.
This decreases the chance for a false negative biopsy."
In addition, prostate surgery is performed laparoscopically using small incisions and a tiny camera. This results in more precise removal of the prostate with less damage to the surrounding tissue, while being easier on patients.
"This approach provides the least-invasive method possible for men with prostate cancer," says Dr. Andriole. "The Siteman Cancer Center will continue to provide the best diagnostic and treatment options for St. Louis and surrounding areas."
For a referral to a urologist at the Siteman Cancer Center, call 314-TOP-DOCS (314-867-3627) or toll-free 866-867-3627.