We need better prostate cancer diagnostics!

I see this as one of the biggest problems with cancer diagnosis - not only finding it but determining how aggressive and wide spread. Leads to a number of bad treatment selections - either too much or too little.

New imaging and tests are on the way. I've seen improvement but it comes painfully slow.
Andrew

We truly do. I agree totally with all of the above. But how do we change that? What is the best way to advocate and get this studied and refined and attention brought to it?

What can we do as normal everyday folk today that will make a difference in the future?

Color Doppler TRUS in addition to a mpMRI before committing to a treatment plan is probably a good idea. Still not perfect, but the additional imaging provides can provide some good information, and is better than forging ahead somewhat blindly based only on a random 12 core biopsy.

The thing is that if you have had a biopsy recently (within 6 - 8 weeks), the MRI results can be compromised. So, ideally the MRI should be done before the biopsy, and the biopsy should be a targeted biopsy guided by MRI or color doppler TRUS to help make sure the suspicious areas are sufficiently sampled.

What persuasive criteria do you suppose it would take for an insurance company to approve an MRI before prostate cancer is confirmed? Elevated PSA? It sounds great to have the MRI first, and certainly gives the best imaging, but they're not cheap. The insurance companies do everything they can to minimize costs.

I had an MRI pretty soon after my biopsy, and we were willing to do it due to the seriousness of the biopsy results. Yes, some of the measurements were compromised due to residual bleeding artifacts, but the images were more than clear enough to see what we needed to see. We couldn't wait several weeks for things to clear up, since a rising PSA and G9 said something serious was going on and needed prompt attention.

Tudpock, that's great! I wonder if maybe he is basing that MRI request on the same criteria that justify a biopsy?

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I had a slight elevated PSA and was scheduled for a DRE. Had I known about the information available at Healing-well and other sites I would have consulted those first just to be better educated and to make better informed decisions.

I think part of this haphazard approach to diagnosis is the financial incentive and the initial fear factor. If I'm a urologist (for example), I'd like to operate, especially - as one of mine had told me - they had just gotten a New DaVinci machine. The more ops the better the offset for the expensive machine. Note, I only had One Gleason 9 core out of 16.

Another of the specialists that I consulted clearly denigrated forums and other non-medico "advice" media, which made the decision making process difficult.

I would certainly like the protocol for establishing prostate cancer to be re-evaluated and potential patients put through a more rigorous testing regime than the current norm. In all I had, a Biopsy, two Body scans for Mets and was then scheduled for a RRP (all in 4 weeks)

I'll review the Australian Cancer Society's information and see if they adequately address the initial diagnosis. Many of the lit that Ive seen address the options once cancer has been "established". It does NOT elaborate on the initial diagnostic options available.

Perhaps there should be a clear diagnostic protocol available, as a first port of call for anyone (Doctor, patient) who suspects that they might have cancer. It was extremely emotional to hear men lament that if they had had better diagnosis, they could have opted for better treatment.

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