From what I understand, prostate cancer is different from most other cancers in that the exact location of the tumor(s) is not known. Apparently, x-rays, CT scans and MRIs are unable to identify prostate cancer cells inside the prostate. Biopsies of tissue core samples extracted from the prostate are needed to determine whether cancer is present or not in the samples. Biopsies do not determine the locations and extent of all the tumors in the prostate. As a result, treatments have tended to treat the entire gland by either removing it entirely or radiating the whole thing to make sure they get it all. The only sure way to determine the exact extent of the cancer is to biopsy the whole thing but that requires removing it from the body first. Someday, there may be some alternatives.
At least two teams of scientists, one in Belgium, the other at UCLA, are working on systems that use computer software to combine data from MRI scans and ultrasounds to map the locations of cancer inside the prostate gland.
The UCLA research team fuses data from a real-time 3-dimensional ultrasound with MRI data during a biopsy to reasonably accurately determine the location and size of prostate cancer tumors within the prostate and, thus, identify the best places to take core samples. It is expected that this technique will be especially beneficial for patients of advanced age with small tumors that will not grow fast enough to ever be life threatening. It is also expected to be useful for patients such as myself who have had high PSAs and a previous negative biopsy.
A Belgian company has developed a product called HistoScanning that couples ultrasound with “advanced tissue characterization algorithms to visualize the position and extent of tissue suspected of being malignant in the prostate gland.” According to the manufacturer, “Prostate HistoScanning™ offers the simplicity of ultrasound and results that are comparable to MRI in a format that can be made available to all patients in the physician’s office.”
Of course, it will be some time before either of these options become available for use in the U. S.