Tuesday, November 17, 2015

Update on Prostate Cancer Diagnosis from Urology Centers of Alabama

By: Dr. Thomas Holley, Urology Centers of Alabama

Prostate cancer continues to be a major public health problem in American men particularly those in Alabama. The death rate in Alabama from prostate cancer is too high. One of the particularly disturbing problems has been the lack of early diagnosis in African American men. Since 2007 we have supported a major effort to bring early detection opportunities to the underserved men of our state.

Recent statistics from the Alabama Department of Public Health have shown that the disparity in early stage at diagnosis between black and white men has been eliminated. We are encouraged that the death rate from prostate cancer continues to decline nationwide as well as in Alabama. Of particular interest the death rate among black men in Alabama has declined at an even faster rate.

The physicians of Urology Centers of Alabama are very concerned that the US Preventive Task Force has recommended against prostate cancer screenings. As a result of their recommendations the incidence of prostate cancer has declined over the past few years. Prostate cancer has not gone away it is just not being diagnosed at the same rate. Our fear is that many of the men who were not diagnosed early will be seen in a few years with late stage prostate cancer. This could have been prevented. The physicians at Urology Centers of Alabama continue to be strong advocates of prostate cancer screening as well as innovations to make screening more effective (see notes below).

Some of the challenges in prostate cancer diagnosis and management involves potential over diagnosis and over treatment. One of the areas of importance is trying to determine which men who have had a negative prostate biopsy should have a repeat biopsy. In an attempt to answer that question Urology Centers of Alabama joined with several national and internationally respected prostate cancer centers to study this problem.

The group found that using a methylation intensity-based algorithm performed on the negative biopsy specimens could help predict which men harbored high grade prostate cancer and thus needed to be rebiopsied.

The implication of this methodology could be far reaching by avoiding unnecessary biopsies and in men with positive biopsies segregating likely under graded men from active surveillance candidates.

Urology Centers of Alabama remains committed to excellences in prostate cancer care.

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