Prostate cancer: State-of-the-art diagnosis and non-invasive treatment

Prostate cancer is the most common cancer and the third leading cause of cancer-related death in American men. In this video, Dr. Steven Raman, director of Prostate MR Imaging and Interventions at UCLA Health and Jhoanna Anuran-Torres, a UCLA Health interventional radiology nurse practitioner, discuss state-of-the-art diagnosis and treatment of prostate cancer.
Learn more: uclahealth.org/radiology

[@scottcampbell7944]

I had the TULSA procedure right before FDA approval so it was still experimental in the USA. Cancer free and much of the prostate volume was reduced. They did not heat the entire prostate, only the affected area.

[@rodneykahn6927]

was that hifu in this video?

[@henryzamora9756]

I'm glad I found this very valuable & informative video. My recent PSA 6.5. Now, I can make informed decision on further testing. I will try locate in South Texas doctors that are familiar this procedure. Thank you Dr Raman.

[@sammschmitz]

That is a great statement about doing what is best for the patient. However, I think that the label of non-invasive treatment in the title is a bit of hyperbole. Putting a probe up the penis and burning out the prostate while under general anesthesia would qualify as invasive to me.

[@inkironmojo775]

AWESOME!!! thanks for sharing .. I feel much more informed

[@thermonaut]

None of the "success-stories" mention the age of the treated patient ! I think this should be important information.

[@MrCyberife]

Definitely have a different idea about what is invasive !

[@charlesblumenstock9160]

I agree anoscope and ultrasound are invasive

[@robgerety]

Are we at the point where all prostate cancer patients with any significant amount of grade 4 cancer in the prostate on biopsy should have a psma pet scan to rule out metastatic disease before selecting treatment options?

[@BigZWD]

I was recently diagnosed with prostate cancer, 2 core sample were 3+4 Gleason score with about 40% cancer and one core sample 4+3 and 60% cancer, PSA has been elevated for and year and a half. First test was 10.1 05/21, now 14.1. Schedule for a CT scan and bone imaging to see if cancer has spread, would this be a good procedure for me. I do live in Los Angeles

[@james17raider22]

My PSA is 11.63 and I’m freaking out!! I asked for the test and when I got the results I noticed eight years ago my numbers were high! so I’m extremely pissed off that it was never addressed or tested again.

[@wenlu5046]

Did you primary care doctor say anything about the elevated PSA?

[@henrylim695]

My PSA was 4.3, PIRAD 4 & 5 , and Gleason 3+3. I am now on AS. Can u provide a second opinion for me if I send my MRI, biopsy , bone scan results?

[@lomasgrandberry7845]

Thanks for the great information

[@robwembley]

Please provide the link to the published paper. Many thanks.

[@AQUA14130]

Wow. Where do you get this type of treatment?

[@paulsdrc]

I had the MRI guided biopsy, 6 samples, very painful . And they missed the targets all 6 times.

[@robwembley]

Really sorry that it was painful. How was your recovery. Did you find ways to aid recovery.

[@paulsdrc]

@@robwembley I got HIFU a couple months later, cancer free 10 years

[@robwembley]

@@paulsdrc Really glad you are now cancer free. Thank you so much for responding.

[@brettm7597]

A couple of items worth noting. My PSA density was .09. Typically, a PSA density over .15 is a trigger point to have a biopsy. If you have .09 or less you typically do not have prostate cancer. My Free PSA was 28%. Typically if your Free PSA is over 25% you don't have prostate cancer. However, a study indicates that if you have an elevated creatinine level in your blood the Free PSA test is useless. With that said, I had two high grade Gleason 8 tumors, two Gleason 7's (a 3+4 and a 4+3) and a Gleason 6. My point of saying all of this is to encourage you to get a parametric MRI to detect lesions. Knowing my numbers indicated that I most likely did not have prostate cancer, I was shocked to learn that I had prostate cancer. Had I not asked for the MRI, I would not have known. Please ask for an MRI to verify things if your PSA trends up over 4. Mine had risen to 5 and I just wanted to confirm things after I read about the study regarding Free PSA being off if you are in the top 25% of normal creatinine levels. Urologists may want to start looking at creatinine levels too!

[@robwembley]

Thank you for sharing this detailed knowledge around markers. It is very much appreciated !

[@Its_just_me_again]

thanks for sharing and congrats on the outcome. i have a crazy story which is still ongoing. im 55 and have had urinary issues since my mid 20s including constant infections and BPH. about 4 years ago, my psa began consistently rising. i got an MRI which produced PIRAD 2 but my urologist did a biopsy anyway which came back negative. my psa continued to rise with no fluctuations. 11 months after my MRI PIRAD 2, i got my 2nd MRI which this time produced a PIRAD 5, identifying a 20mm lesion with ADC 0.75 and type 3 pattern. indicating extremely likely to have high grade cancer. my PSA had increased from about 3.5 to 6.6 (i got PSA bloods about every 3 months and the increase was steady always). he did another biopsy and it also came back negative. my PSA continued to rise 8.2 with free PSA at 10%. i decided to get my 3rd MRI and this time... lol it was PIRAD 2 again. i found a new urologist who was very thorough and looked at all of my previous MRIs and biopsies before we met. He said it appeared my old urologist hadnt even looked at the MRI images or report as he didnt target the area of the lesion but instead did systematical samples. he only took one from where the legion was reported. that core came back unremarkable but other cores in different locations came back with chronic infection evidence. he added after my biopsy if i did have cancer, it was probably very small. (the lesion reported was 20mm - quite large!) if not cancer, you would expect to find something if that core hit the marked area. so, my new urologist said he agrees with the 2nd MRI findings of PIRAD 5 and was very concerned with the legion. he decided to do a targeted biopsy, using the MRI images from a couple of years ago, under local and rectum ultrasound. to both of our surprise, the 4 good cores came back clear of cancer. i feel somewhat numb when i should feel relief. probably because there are so many independent data points suggesting cancer and the lack of definitive results from all these tests as mentioned in this video. it feels like i have not dodged a bullet but have just had it missed several times. it is hard trying to relax as it hangs over my head. i worry that instead of having the advantage of early detection, i will one day find out that i have had it for years and just hope it has not gone metastatic.

[@goyo2897]

@@Its_just_me_again It would seem that a PSMA-PET scan would be in order in your case

[@Its_just_me_again]

@@goyo2897 since my post i DID in fact have a PSMA-pet which showed mild asymmetric uptake local to the prostate. so then i did another MRI with the best radiologist in the country and got another PIRAD 2... my urologist wants a saturated biopsy. im waiting for my PSA index bloods to come back. it feels like i will be getting a biopsy every year until they find what they believe to know :( thx for taking the time to respond

[@goyo2897]

@@Its_just_me_again Well, you sound like you're going to be in good shape. Here are some points for consideration: (1) see if you can find a Prostate or Urologic Oncologist to review your case from top to bottom. Urologists handle a ton of issues and prostate cancer is only one. It generally comprises only a small part of their practice. Oncologists just do cancer and your case is definitely somewhat confounding. (2) A saturation biopsy is a cash cow for your doctor and can be hazardous to you. I"m not saying don't do it; I'm saying consider getting other opinions before you expose yourself to this serious procedure. (3) Don't feel rushed. (4) Inflammation in the prostate mimics cancer on MRI and has a tendency to cause PSA to rise and it causes free PSA to drop. My PSA went up to 18 about 6 months ago and went back to about 8 after treatment. (5) Always consider getting 2nd opinions on your pathology. Remember that it is the PATHOLOGIST who identifies cancer, not your doctor so be sure to get a good one and consider 2nd opinions.

[@enricog9540]

Where can I get an evaluation in Austin, Tx. or near for these treatments? thank you.

[@user-qj2wb7ne4e]

Dr. Geiger at Austin Urology, Westlake office.

[@olaposimarcus8407]

Giving thanks to Dr Edos always is what I want to do cause he brought me back to my full health with his herbal medication i say a big thank you to #Dredos.

[@cedricansley7642]

Do you have a recommendation for doctor and facility in Houston, TX?

[@taiwanluthiers]

I got a question... I know MRI is a giant magnet and so no metal is allowed during an MRI, so how are MRI guided biopsy done with a needle? Do they use non metallic needle?

[@rodneykahn6927]

Nonferrous needles of pure brass, titanium, or copper, and ferrous needles of different alloys of stainless steel

[@rodneykahn6927]

For use inside an MRI system, the Ovipositor MRI-Needle must be at least MR conditional and MR compatible. Nitinol is metallic and, therefore, MR conditional at best. Nitinol is paramagnetic www.ncbi.nlm.nih.gov/pmc/articles/PMC9451087/

[@garylay2917]

❤

[@ShivaniSuri-fs5tz]

Nice but we can also have Varundi vati and varundhi capsules from Planet Ayurveda for better results.

[@BigZWD]

😬 oops, I forgot 59 years old , African American, non smoking, light drinker and relatively in good health,,, except for the obvious 😉 😜,, gotta keep a good humor about this, it's the only thing keeping me sane

[@user-ev9sw4ee8j]

I think it's really important to educate ourselves on prostate cancer- what it does to the body - what to do if you have it, and how to prevent it. contact (Dr Oyalo) on channel for natural cure on his channel. i got cured with his remedy.

[@JDinky652]

Therapy should be possible with enough weight of evidence that does not include an invasive biopsy (which comes with the risk of infection and spreading of cancer to the rest of the body).

[@bogtrotter5110]

Gee, and all you need is money.

[@mtgramza]

Or good medical insurance.

[@olaposimarcus8407]

Giving thanks to Dr Edos always is what I want to do cause he brought me back to my full health with his herbal medication i say a big thank you to #Dredos.

[@miriamtrowsdale5]

Hello Marcos could you please tell me what herbal medication did you take.