Health Team

New imaging detects more prostate tumors

Posted January 1, 2015 5:30 p.m. EST
Updated January 2, 2015 11:41 a.m. EST

— Prostate cancer is the second most common cancer in men and accounts for 22 percent of all male cancer deaths. Conventional screening methods miss many prostate tumors until they become advanced, but new imaging techniques are improving the odds of survival.

Mark Youngquist, 58, says his older brother's fight with prostate cancer changed both of their lives.

“It was from that experience that he encouraged me to be more proactive about getting my tests done,” he said.

Youngquist's past exams, including PSA blood tests, were always low, until about a year ago when his number doubled. The rate of increase alarmed him, so he went to Duke University Hospital for more tests, including a needle biopsy on the easier-to-access posterior end of the gland. It found no cancer.

“But some of the tumors that aren't found on the posterior part of the gland can be very aggressive,” said Dr. Rajan Gupta, a Duke radiologist.

Gupta and Dr. Thomas Polascik, a Duke urologic surgeon, say new imaging technology using MRI eliminates a lot of guess work.

“In the past, all biopsies that were done were done in a blind fashion,” Polascik said. “We can see these tumors and then biopsy them specifically.”

Different images, including contrast dye to reveal abnormal blood flow, confirmed what Youngquist suspected.

“I lit up like a Christmas tree, but the part of me that had the cancer, the part of my gland, was the top hemisphere, not the bottom,” he said.

This time, biopsies guided by ultrasound and MRI images came up positive. Using 3D models to help guide him, the surgeon was able to remove the tumor. For Youngquist, it was successful.

“I'm cured,” he said. “I don't have what typically are the problems associated with prostate surgery – incontinence, erectile dysfunction.”

Youngquist now tells other men over 50, or with other risk factors, to be proactive about catching prostate cancer early.

The Duke Cancer Center is the only one in the state currently using parametric MRI/utrasound fusion biopsies. Many insurance companies may not cover the costs unless a biopsy result is positive.