Prostate cancer is the most commonly diagnosed cancer among men in Canada. In fact, as many as one in nine men will be affected in their lifetime in North America. The good news? Prostate cancer mortality has decreased over the last two decades due to advances in screening, diagnosis, and treatment options.
There are several risk factors associated with the development of prostate cancer, including age, family history, high-fat diets, and being of African American descent. Detecting the disease early, identifying and monitoring men at risk, and providing the appropriate level of observation for indolent disease or treatment for more aggressive forms are key factors in reducing the impact of prostate cancer.
Both disease awareness and the use of diagnostic tools have contributed to improved intervention and more accurate detection. Prostate cancer can be present for many years before symptoms appear, so it’s important to have tools to both detect the disease and understand how aggressive it is before determining next steps. Some men may need to be monitored more closely, while others will need to move rapidly towards treatment.
Prostate-specific antigen (PSA) testing has been available to Canadians for a few decades, and remains an important tool used for diagnosis and disease monitoring. It’s often used in conjunction with a digital rectal exam (or DRE), both of which may already be familiar terms to many men. In order to confirm diagnosis, the gold standard is to perform a prostate biopsy and examine cells for signs of cancer.
It’s important to have tools to both detect the disease and understand how aggressive it is before determining next steps.
Advancements in diagnostic tools lead to better outcomes
What most people may not be aware of is the array of other tools already used to provide further information at various stages. These tools are especially useful to help reduce overdiagnosis and overtreatment of slow-moving disease that’s not life-threatening. Multiparametric MRI is an imaging technology that’s increasingly used to support diagnostic decisions. In addition, new prostate cancer biomarker tests like SelectMDx help health care practitioners determine which men require invasive diagnostic procedures like a biopsy. For any of the tests mentioned, men should have a conversation with their physician about what makes sense to include for their individual needs.
According to Dr. Alexandre Zlotta, director of Uro-Oncology at Mount Sinai Hospital, “Pinpointing men at risk of harbouring an aggressive form of the disease and minimizing the number of biopsies in men with the indolent form is an important unmet need. We are now moving away from a “one size fits all” toward a more personalized, smarter prostate screening approach, keeping the benefits while reducing the harms.”
The last two decades have seen major progress in outcomes for prostate cancer patients. Advances in molecular diagnostics, imaging, artificial intelligence, and other tools continue to be developed, and the next decade holds promise to continue this trend.