Dr. Laurence Klotz of Sunnybrook Health Sciences Centre is a world leader in the field of prostate cancer research. He has been a champion of active surveillance (also known as watchful waiting) for over 20 years, an approach to prostate cancer treatment that has allowed thousands of men with low-risk prostate cancer to avoid or delay therapy by monitoring it closely instead of immediately treating it.
Now Klotz has launched a new clinical trial called PRECISE, funded with $3 million in support by the Movember Foundation, the Ontario Institute for Cancer Research and Prostate Cancer Canada, that will use MRI to help to better diagnose prostate cancer without invasive biopsy.
“If positive, this trial would support a change in practice from relying on biopsies for all men with suspected prostate cancer to providing MRI first with selective targeted biopsy,” explained Klotz in a statement. “This would allow 250,000 men per year in the U.S. and Canada to avoid unnecessary biopsies and the associated complications including hospitalization, without compromising our ability to identify clinically significant cancers.”
Current standard of care relies on ultrasound-guided biopsy for men who have an elevated PSA score (an early indicator of the possibility of cancer). The technique uses ultrasound imaging to locate suspicious areas of the prostate and then biopsy those sections using a needle. This approach has two major drawbacks: one, it has potential side effects because it requires surgery and the taking of multiple tissue samples, and two, ultrasound imaging is not specific enough to accurately detect disease, so cancerous tissue may be missed in the biopsy procedure.
If positive, this trial would support a change in practice from relying on biopsies for all men with suspected prostate cancer to providing MRI first with selective targeted biopsy
MRI is much more accurate, giving doctors a better picture of the prostate – so much so, in fact, that they could determine with accuracy if many cancers are present or not with an MRI scan alone. If it were present, patients would go for targeted biopsy. If not, they could go home. The trial will, over the next three years, compare MRI imaging for prostate cancer detection versus the current standard of care, and if it proves successful, would change how patients are treated across Canada.
The trial is scheduled to launch soon at cancer centres in Ontario. Individuals who are interested in participating in the trial should first speak to their oncologist to determine whether the trial would benefit them.