Many in the prostate cancer community will have reacted with grave concern over yesterday’s news that MRI scanners and the expertise needed to use them are in short supply in the NHS as we emerge from the Covid-19 pandemic and face a backlog of cancer patients.
MRI scanners are not only an essential part of diagnosing prostate cancer. They are the very reason that prostate cancer patients today have more options in their treatment, and are the foundation for non-invasive procedures.
Not only does the MRI allow for us to see where the cancer is, measure how big it is, and determine how severe it is, it forms the basis for the entire diagnostic and treatment pathway.
To understand its targeted treatment, let’s work backwards through the diagnostic supply chain. Focal therapy needs an accurate map of where the cancer is to treat. The map is based on a biopsy report showing which areas need to be treated. The biopsy report is based on a biopsy plan showing areas of suspicion to sample and test. The biopsy plan is done by an expert radiologist who reads an MRI scan and applies technology and knowledge to identify areas of interest for biopsy. The MRI scan requires a radiographer to ensure the patient is best positioned to capture the required images and to operate the scanner. The scanner needs to be calibrated a certain way to maximise image capture, and needs to be maintained to ensure consistent quality.
The consulting urologist that makes a diagnosis of prostate cancer and recommends treatment based on its scale and severity is relying on all of this information in a consistent, comprehensive and straightforward report, something that is often unavailable in the NHS.
Focal Therapy and Active Surveillance alike depend on seeing cancer with great accuracy. Without the capacity to do this, we risk regressing back to the dark days of once-size-fits-all radical treatment that cures the cancer but damages the man.
That’s why at TFTC we maintain the highest standards of MR imaging, using world-class radiologists who report with unmatched accuracy and precision to our consulting urologists.
Without good imaging, we have no focal therapy.
Read more on this topic in this article in The Guardian.