When caught early, prostate cancer is easily treatable. We believe that it is important to diagnose men, where possible, in the early stages when they have better options for curative treatments, which can be done with fewer side effects.
Over the last decade, developments in MRI imaging and biopsy procedures have made it possible for more accurate and earlier diagnoses to be made at a point when patients have increased options for treatment that is both curative and minimally invasive.
The Diagnostic Procedure
If you have had a PSA test and are found to have an elevated PSA that has persisted for a period of time, further investigation by a consultant urologist will be needed.
Your consultant urologist will normally conduct a DRE test to check for any obvious abnormalities and is also likely to refer you for an MRI scan. The MRI scan is used to identify areas of suspicion within your prostate gland that may need to be further investigated.
The radiologist reviewing your MRI scan will identify areas of suspicion shown in the scan and will assign them a PIRADS score. A PIRADS score of 4 or 5 indicates a need for a biopsy, and a significant number of men with a PIRADS score of 3 will also be biopsied.
Approximately 60% of men who have an MRI scan will progress to have a biopsy.
The biopsy takes samples of cells from the areas of suspicion within the prostate gland that are then stained and mounted onto slides in the laboratory to be checked under microscope by a pathologist. The pathologist will review the slide and report on the presence of any abnormality including prostatitis or prostate cancer.
Whenever possible, it is preferable for men to have a modern trans-perineal biopsy rather than a traditional trans-rectal biopsy. In a trans-perineal biopsy, the needles are sent through the skin rather than the rectum. Consequently, there is a greatly reduced risk of infection (less than 1 in 1000) and significantly improved accuracy, thus providing a broader range of treatment options in the event of a positive diagnosis. Trans-rectal ultrasound biopsy, the traditional method, has a relatively high risk of infection (approximately 1 in 30) and lower accuracy.
Following your biopsy, you may then receive a confirmed diagnosis of prostate cancer.
Your diagnosis will contain information which tells you:
- How aggressive the cancer is, indicated by the Gleason Grade.
- The stage of the cancer, which will show the progression, size and location of the tumour.
As a group of consultants we are passionate about prostate cancer sufferers knowing about all of their treatment options.
We know that settling on the right treatment is a big decision for you. If you would like to speak to one of our friendly and knowledgeable patient advocates about your diagnosis and the HIFU Focal Therapy treatment option then please do not hesitate to get in touch today.
All enquiries to The Focal Therapy Clinic are confidential, and we are delighted to offer our advice and support with no obligation.