Tumour Imaging Set To Improve Surveillance And Management Of Prostate Cancer
International cancer experts believe the time is right for tumour imaging to play a more pivotal role in advancing and improving prostate cancer care. Tumour imaging offers an accurate means of characterising and mapping the true volume and extent of prostate cancer.
During a high level meeting of medical professionals earlier this month (6 and 7 May 2008), organised by Pelican Cancer Foundation - the national charity dedicated to the development and teaching of surgery for pelvic and liver cancers - an international group comprising surgeons, radiologists, oncologists, scientists and patient representatives concluded that contemporary tumour imaging technologies have the potential to change the way prostate disease is both evaluated and treated.
While prostate cancer is the most common male cancer, with an incidence in the UK of between 15-30 per cent in men over 50 years of age, rising to 60-70 per cent by age 80 years, only one in 25 men die from the disease, with more men likely to die with prostate cancer than from it.
According to meeting chairman, Mr Mark Emberton, Reader in Interventional Oncology, University College London (UCL), non-invasive imaging could help cut down on repeated tissue biopsies, prevent over-aggressive surgical approaches to treatment and so help reduce much of the unnecessary morbidity associated with current prostate cancer surveillance and management.
The meeting received reports of research from the UK, the USA and France that identify 1.5T magnetic resonance imaging (MRI) as currently the most effective and widely available imaging method to detect, pin-point and help quantify tiny zones of cancerous tissue in the prostate.
Now international experts are calling for 1.5T MRI scanning to be used earlier in the characterisation of disease and before biopsy.
One of the greatest challenges after staging disease and distinguishing between men with advanced disease and those with low volume, non-metastatic disease, is how best to manage patients with low volume disease.
Current options range from radical therapy, to focal therapy that will ablate only parts of the prostate considered affected by clinically significant cancer, or active surveillance - involving regular assessments and tests for disease progression.
Radical therapy often involves removal of healthy tissue in an attempt to ensure complete removal of cancer and can cause functional damage, sometimes affecting sexual potency and function.
Focal therapy ablates discrete areas of known cancer in the prostate and can offer men a treatment option to control disease while preserving maximal amounts of healthy tissue.
Active surveillance by contrast involves no immediate intervention but rather carefully monitors the disease progression.
The meeting delegation plans to form a steering group to help integrate imaging into the routine clinical management of prostate cancer. It believes that a programme of clinical research, together with educational guidance and support for standardised reporting of imaging data, will allow prostate tumour imaging to play a major part in cancer management.
Mr Emberton concluded that image directed focal therapy has the potential to be as significant a development for the management of prostate cancer as the change in practice from regular mastectomy to less radical surgical intervention in breast cancer.
Notes
1. Spokespeople are available for interview
2. The Pelican Cancer Foundation, based at The Ark, Basingstoke and North Hampshire NHS Trust, supports advances in the treatment of a number of common cancers, including urological cancers. Pelican pioneered the introduction of routine MRI assessment for patients with bowel cancer, and was commissioned by the Department of Health to deliver a national multidisciplinary educational programme on total mesorectal excision - a procedure acknowledged as one of the most successful and cost-effective NHS interventions in rectal cancer.
Pelican Cancer Foundation
Tumoralã set de imagini pentru a îmbunãtãþi supraveghere ºi de management al cancerului de prostatã - Tumour Imaging Set To Improve Surveillance And Management Of Prostate Cancer - articole medicale engleza - startsanatate