Prostate Restored
Prostate Restored
Photo: Stacey Gabrielle Koenitz Rozells
The analysis included 461 lesions from the 441 patients identified. The mean radiologic tumor size was 1.57 cm, whereas the mean pathological tumor size was 2.37 cm.
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Read More »Magnetic resonance imaging (MRI) is often used in the diagnosis and management of prostate cancer, but the method frequently underestimates tumor size, a study from the UCLA Jonsson Comprehensive Cancer Center found. The study, published in The Journal of Urology, aimed to assess radiologic tumor size vs actual pathological tumor size in patients with prostate cancer and to identify predictors of pathological tumor size. Researchers assessed a cohort of 441 men with biopsy-proven prostate cancer and 3 or higher index lesions based on the Prostate Imaging Reporting and Data System version 2 (PI-RADSv2) who later underwent radical prostatectomy. They defined radiologic tumor size as the maximum tumor diameter determined by the MRI and compared those measurements to those found in the whole-mount histopathology after resection. The analysis included 461 lesions from the 441 patients identified. The mean radiologic tumor size was 1.57 cm, whereas the mean pathological tumor size was 2.37 cm. Although tumor size was consistently underestimated in the radiologic setting, tumors that were smaller and had lower PI-RADSv2 scores tended to be further underestimated than others. In cases where tumors were categorized as grade 5 on the Gleason Grade Group (GG), pathological tumor size was larger compared with GG grade 1 tumors, with a mean change of 0.37 cm (P = .014). Lesions rated 5 on the PI-RADSv2 index also had pathological tumor sizes larger than PI-RADSv2 4 lesions, with a mean change of 0.26 (P = .006). Tumors with higher prostate-specific antigen density were also larger. Overall, there was not much correlation between radiologic tumor measurements and pathological tumor size in the cohort. The researchers saw correlation coefficients ranging from 0.1 to 0.65. Inaccurate tumor measurements can make it difficult for physicians to see where the outer edges of the tumor end and healthy tissue begins, potentially leading to insufficient treatment when the measurements are underestimated.
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Read More »It is nearly impossible for a man to retain his ability to father children through sexual intercourse after initial treatment. During prostatectomy, both the prostate and the nearby seminal vesicles are removed.
It is nearly impossible for a man to retain his ability to father children through sexual intercourse after initial treatment. During prostatectomy, both the prostate and the nearby seminal vesicles are removed. Seminal vesicles and the prostate provide semen that carries the sperm down the urethra and out the penis during ejaculation. The loss of semen following surgery makes ejaculation impossible, so the sperm cannot physically leave the body. Radiation therapy nearly always impairs fertility. Radiated prostate cells and seminal vesicles tend to produce semen that cannot transport the sperm well. Sperm can also be damaged, though this occurs far less frequently with more accurate dose planning.
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