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PROSTATE CANCER SCREENING AND DIAGNOSIS: TRANSRECTAL ULTRASOUND

by admin - March 27th, 2009.
Filed under: Men's Health-Erectile Dysfunction. Tagged as: , .

Like sonar on a submarine, ultrasound draws pictures using sound waves. Transrectal ultrasound can detect differences between cancerous and normal tissue in the prostate by means of a special probe, inserted in the rectum. In most cases, it allows doctors to see the entire prostate. This transrectal (through the rectum) approach is a big improvement over a lower-frequency, lower-resolution technique used several years ago, in which sound waves had to travel all the way through the abdomen to reach the prostate. Transrectal ultrasound is able to detect cancers that can’t be felt in a digital rectal exam; it has been found to have a detection rate of 2.6 percent—as opposed to the 1.3 to 1.7 percent rate for digital rectal exam and the 2.2 to 2.6 percent rate for PSA. And, many men with prostate cancer detected by transrectal ultrasound (and missed by digital rectal exam) who went on to have surgery, a radical prostatectomy, to treat the cancer were found to have disease that was confined to the prostate. In other words, thanks to ultrasound, for these men the cancer was found in time to cure it.

Encouraging results. And, just as doctors had hoped PSA would become a “male Pap smear,” many hoped transrectal ultrasound could be a “male mammogram,” another means of screening for and detecting prostate cancer early. That hasn’t happened yet. Transrectal ultrasound is neither quick nor cheap, and the results often depend on the skill of the doctor using the ultrasound equipment. So right away, these three factors rule it out as the perfect tool for routine screening—it’s just not worth it to use transrectal ultrasound on everybody.

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