Madrid, June 7 2023-. The figures estimate that this year there will be 29,002 new cases of prostate cancer in Spain. It represents the most frequent tumour in men and is the third most common cause of death from cancer among them1. For this reason, early diagnosis is vitally important to prevent complications with the condition spreading and to begin medical or surgical treatment as soon as possible. This has led to the introduction of new equipment and diagnosis tools such as fusion biopsy, a technique that enables greater precision when identifying, above all, the small tumoural lesions in enlarged prostates that can complicate exploration.
In the words of Dr. Carlos Núñez Mora, Head of the Urologic Surgery Department at the MD Anderson Cancer Center Madrid, “this system employs a software to combine the magnetic resonance imaging and ultrasound scans that we have previously taken of the patient’s prostate. This enables us to obtain a three dimensional map of the suspicious areas that helps us make a guided biopsy. This is especially important when, for example, we need to locate a very small lesion, scarcely 4 mm in size, in a prostate of 60 cm3, cases where the technique becomes significantly more complicated”.
The expert added that “what this software does is topographically select the ultrasound images; in other words to produce a three dimensional reconstruction of the prostate, which it compares with a three dimensional reconstruction of the magnetic resonance imaging before proceeding to combine the two. In this way, the software indicates where the lesion is within the image and facilitates its search. We doctors then need to look for the point where we can see the lesion before performing the biopsy exactly in that area”.
In addition, according to Dr. Núñez, another advantage of the fusion system is that it will replace the so-called saturation biopsy, a technique used previously before this type of technology existed. As the MD Anderson Madrid urologist recalls, “years ago, in order to avoid incorrect diagnoses, more than 40 biopsies could sometimes be performed on the same patient if necessary. In this way, they ensured that the margin of error was very small. Nowadays, we collect around 3 or 4 samples from the suspicious area and then produce a mapping of 6 to 10 images”. This makes the whole test procedure less invasive for the patient.
Lastly, the device offers benefits in relation to focal therapy given that in the case of patients who are candidates for this type of therapy, (those with low risk prostate cancer) doctors already have the fused images of the lesion saved on the system. Using this same fusion technique, the team can quickly begin a much more precise focal therapy, given that they have already identified the lesion to be treated and its exact location. As they explain from the monographic centre, focal treatment of prostate cancer is a highly selective and minimally invasive procedure, with excellent results in selected cases and minimal side effects in regards to urinary incontinence or reduced sexual potency.
The early diagnosis of prostate cancer is fundamental to planning a less invasive and more personalised treatment
Over recent decades, the number of identified patients with prostate cancer has increased, partly due to the early detection work performed by health professionals. The main objective of this early diagnosis is to achieve a decrease in invasive cases and a reduction of mortality rates.
Currently, the diagnosis of the majority of prostate cancer cases occurs in an initial phase, generally after detecting a high PSA (prostate specific antigen) or an alteration in the rectal examination. Subsequently, if they suspect the presence of a tumour, the specialist will recommend proceeding with imaging tests followed by fusion biopsy as necessary. This prompt diagnosis and early detection work on this type of tumour is fundamental when it comes to deciding the most appropriate and least invasive treatment for each patient, reducing complications and side effects such as changes in urinary function, intestinal problems, sexual impotence or infertility.
- Spanish Medical Oncology Society (SEOM) – Cancer figures in Spain 2023