For men with an abnormal PSA, there are now additional tests that may be considered before prostate needle biopsy. These include prostate Magnetic Resonance Imaging (MRI) and other genomic tests such as the 4k test and the Prostate Health Index (PHI).
At Weill Cornell Medicine, we utilize a 3D imaging device in order to fuse an MRI scan of the prostate with an ultrasound image in real time. This allows the urologist to accurately pinpoint areas of interest within the prostate and target biopsy needles to take samples from these specific areas. Additionally, this allows us to sample the exact locations again in the future if the patient returns for a follow-up biopsy, yielding precise tracking of any cancer progression.
If prostate cancer is detected, it is stratified into risk categories of low, intermediate and high risk. Additional educational resources on prostate cancer risk stratification and diagnosis are provided through the NCCN Guidelines.
Additional work up with imaging (bone scan, CAT scan or MRI) and treatment options are based on a man's prostate cancer risk stratification.
Learn more here about having an MRI or CT scan performed at Weill Cornell Medicine.
Locally advanced prostate cancers may obstruct urinary flow and/or cause severe irritation in the bladder region when the cancer extends from the prostate into the base of the bladder. Treatment of this locally advanced cancer can be very difficult. Obstruction to urinary flow may be opened by transurethral resection of the prostate, but there is a delicate balance between opening the urethra adequately to void, and opening the urine passage too much, resulting in incontinence.