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Clinicians
map group at High Risk for Aggressive,
'Hidden' Prostate Cancer
Newswise
— Clinical researchers at Princess Margaret
Hospital (PMH) can now answer the question
that baffles many clinicians - why do some
men with elevated prostate specific antigen
(PSA) levels who are carefully monitored and
undergo repeated negative biopsies still
develop aggressive prostate cancer?
The answer is hidden tumours located on the top of the
prostate that evade traditional diagnostic
procedures, including ultrasound-guided
needle biopsy.
The PMH research, published online today in the British
Journal of Urology International (BJU
8938), demonstrates that magnetic resonance
imaging (MRI) is the best tool to reveal
such tumours.
"Our findings identify a specific high-risk group whose
tumours are difficult to diagnose because of
location. These men benefit from MRI, which
guides the biopsy procedure with a high
degree of accuracy," says author Dr. Nathan
Lawrentschuk, Urologic Oncology Fellow, PMH
Cancer Program, University Health Network.
"The research team calls the clinical presentation of
elevated PSA and repeated negative biopsy
results in 'prostate evasive anterior tumour
syndrome' (PEATS)."
"Knowing about PEATS may also be important for men already
on 'active surveillance' - patients with
slow - growing prostate cancer who are being
regularly monitored through PSA testing and
biopsy.
"Every man does not need an MRI, but knowing about PEATS
will help us identify those who do," says
principal investigator Dr. Neil Fleshner,
Head of the Division of Urology, Princess
Margaret Hospital, Professor of Surgery at
University of Toronto, and Love Chair in
Prostate Cancer Prevention Research.
A team of urologists, surgeons, radiologists and
pathologists studied 31 PMH patients who had
positive biopsy results and tumours on top
of their prostate as shown on MRI. They
found that MRI was able to help diagnose
hidden prostate tumours 87% of the time.
Dr. Lawrentschuk says clinicians need to be aware of PEATS
because these hidden tumours can be
aggressive.
About Princess
Margaret Hospital
Princess Margaret Hospital and its research
arm, Ontario Cancer Institute, have achieved
an international reputation as global
leaders in the fight against cancer.
Princess Margaret Hospital is a member of
University Health Network, which also
includes Toronto General Hospital and
Toronto Western Hospital. All three are
research hospitals affiliated with the
University of Toronto.
www.uhn.ca
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