STAGING PROSTATE CANCER: MORE ON TRANSRECTAL ULTRASOUND AND STAGING
Most studies have found transrectal ultrasound to be a rather mediocre predictor of the presence of cancer that has penetrated the prostate wall, and to be downright poor in finding cancer that has reached the seminal vesicles. In two studies, only 30 percent of tumors that had spread to the seminal vesicles could be found by ultrasound. One investigation, of thirty men undergoing radical prostatectomy, found ultrasound’s sensitivity in spotting cancer that had worked its way beyond the prostate wall was a measly 5 percent. Another study, comparing ultrasound and pathological staging in 121 men, found ultrasound’s overall accuracy in staging was only 66 percent—better, but still not reliable enough. And a multicenter study of 230 men found that ultrasound correctly staged 66 percent of locally advanced cancer and only 46 percent of the cancers confined to the prostate.
Ultrasound’s main difficulty is its inability to “see” microscopic cancer spread. So, to sum up: No definitive decision about a man’s course of treatment should be made on the basis of ultrasound alone, and ultrasound readings shouldn’t be the cause of a man’s exclusion from surgery that could potentially cure his disease.
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Tags: Erectile Dysfunction, Men’s Health