1 out of 6 men will develop prostate cancer throughout his life. Only 1 out of 33 dies due to this malignancy. This discrepancy is due to the broad spectrum of this disease.
Nowadays the the first alert is an elevated PSA value, nevertheless the diagnosis is always by finding malignant cells on the prostate biopsy - Prostate cancer is always assymptomatic on the early stages. (Urinary bother usually is associated with BPH (Benign prostatic hyperplasia)
Random prostate biopsy(6-12 frag.)
The new paradigm
Transperineal fusion guided prostate biopsy
Focal Therapy Active surveillance Whole gland/radical therapies
• mpMRI allows for a precise and reliable location of the cancer foci. When normal it is highly unlikely to find a clinical significant prostate cancer ( negative predictive value around 95%).
• The transperineal fusion biopsy is based on a enhanced reality system that superimposes the MRI, previously aquired, over the realtime ultrasound. Being done through the skin and not the rectum the rate of infection(prostatitis) is near zero. It can be done under local or general anesthesia.
• Nowadays numerous cancers are treated with a focal strategy, when possible : breast cancer, kidney cancer for example. The advantages of this approach are related the the lower side effects, preserved function and enhanced cosmesis, but there is a need for a precise location of the tumors.