Overused Random Biopsies: The Real Culprit

For those not familiar with the name of California oncologist Mark Scholz, MD, he is the co-author of a book provocatively titled “Invasion of the Prostate Snatchers.” Currently, he is the Medical Director of Prostate Oncology Specialists, and also serves as Executive Director of the Prostate Cancer Research Institute. As a respected authority on prostate cancer, and an advocate of getting correct information to patients, when Mark Scholz speaks he has my attention.

In an article in the patient publication Prostate Cancer Communication (Fall, 2014)[i] Dr. Scholz’s opening salvo goes to the core problem of over-treating men with low grade cancer. He observes,

While the PSA blood test has been fingered as the problem, overuse of random needle biopsies is the real issue. Over a million men undergo biopsy every year to evaluate the possibility of harboring cancer. Few people realize, however, that random biopsy reveals low-grade prostate cancer in one out of five men in the general population—even when PSA is normal.

He goes on to say that despite the known risk of side effects, 85% go ahead with radical treatment.

Slowly, as the extent of over-diagnosis and over- treatment is dawning on patients, doctors, professional organizations and even the U.S. Government, solutions are being explored. The simplest, most elegant solution—the one discussed in Dr. Scholz’s article—is imaging.

Basically, today’s imaging such as our 3T multiparametric MRI can detect suspicious lesions with a high degree of accuracy, even higher when done by an expert on state-of-the-art equipment. Imaging before biopsy is essential for two reasons:

  1. It can determine whether a biopsy is truly necessary at that time, and
  2. If so, it can guide a targeted biopsy that requires a minimum number of needles yet yields the greatest accuracy.

I have had the good fortune to meet Dr. Scholz over a dinner. Although we’re located on opposite shores and practice two different specialties, we share a professional common ground when it comes to the best way to serve patients’ needs. I wholeheartedly agree Dr. Scholz’ premise that the conventional use of random biopsy is the true culprit, driving men into overtreatment.

If you are interested in our 3T mpMRI guided biopsy, call us at (877)605-2737 for a consultation.

 

 

 

 


[i] Scholz, Mark. Imaging is superior to random biopsy. Prostate Cancer Communication, a publication of PAACT (Grand Rapids, MI). 2014;30(3):10.

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