As National Prostate Cancer Awareness Month in the United States comes to a close, a Thousand Oaks radiologist is urging men to become more proactive about prostate health the way women have become proactive regarding breast health.

Dr. Robert Princenthal, president of Rolling Oaks Radiology in Thousand Oaks and director of women's imaging and prostate imaging, also wants Ventura County men to know about a relatively new prostate MRI diagnostic system available at Rolling Oaks Radiology. The system combines advanced MRI imaging and biopsy techniques to locate and obtain targeted tissue samples to detect prostate cancer early.

The DynaCAD and DynaTRIM MR technology will soon be available as well at the new Rolling Oaks Oxnard imaging center, scheduled to open in late October. A new women's imaging center at the same location — 1901 Rice Ave. — opened about a month ago.

Rolling Oaks Radiology, the largest imaging provider in the Conejo and Simi valleys, was one of the first facilities nationwide to offer the magnetic resonance (MR) technology to locate and identify prostate cancer. The technology and procedure is currently available at about 50 facilities nationwide.

Rolling Oaks Radiology in Thousand Oaks was one of the first five imaging centers in the United States to have access to the new DynaCAD and DynaTRIM MR technology while it was tested for approval by the U.S. Food and Drug Administration. The FDA approved the system two years ago.

Princenthal hopes it will increase awareness of prostate cancer testing. He said all men age 50 and older should be tested regularly.

"Men need to lean how to fight like women. The parallels between prostate cancer in men and breast cancer in women are remarkably similar," he said, noting that about 210,000 men and women get prostate and breast cancer, respectively, each year, and about 32,000 men and women die of each disease annually.

Yet, the National Cancer Institute spends more than twice as much money to fund breast cancer research as it does to fund prostate cancer research ($631,228,554 spent in 2010 on breast cancer research compared to $300,466,914 spent on prostate cancer research, according to the institute's website), in part because men haven't demanded the attention, said Princenthal, who is on a nationwide task force on optimizing prostate imaging and interpretation under the auspices of the American College of Radiology.

"Men don't talk about the prostate," he said, due to the sensitive issues of impotence and incontinence, both possible side effects for some patients.

"Women became more knowledgeable and learned to fight and they changed the way medical care was given out. Men are 20 years behind," he said.

The general standard of care to check for prostate cancer has involved prostate-specific antigen (PSA) testing as a first step. PSA is a protein produced by cells of the prostate gland and the test measures the level of PSA in the blood. Men typically have a low level of PSA in their blood but conditions like prostate cancer can increase PSA levels. If PSA levels are escalated, a physician usually then performs a digital rectal exam to check the prostate for bumps or abnormal areas.

If a rectal exam shows sings of a problem, then a trans-rectal ultrasound-guided biopsy can be performed. In this procedure, multiple tissue samples are gathered. Unfortunately, Princenthal said, the six to 12 samples are taken from random areas and may produce erroneous negative results.

The new DynaCAD and DynaTRIM MR technology allows doctors to conduct targeted MRI exams of suspicious regions where a tumor might be located, using software for viewing and analyzing the images. This procedure eliminates the need for multiple ultrasound-guided random biopsies and offers better success, Princenthal said. The streamlined biopsy process requires a reduced number of samples, generally two to four, and helps to pinpoint suspicious areas in the prostate. The new system is from Invivo Corp., a company that develops and manufactures medical devices that enhance MR image quality.

Princenthal said about 300 patients have had the procedure at the Thousand Oaks center. In the cases where the new procedure was recommended and performed, the cancer detection rate was 77 percent; by comparison, the cancer detection rate is about half that using ultrasound-guided biopsy, he said. "We can help identify men in the classification of 'active surveillance' in an accurate fashion."

The MRI biopsy which uses the DynaTRIM technology costs about $995, which is covered by many insurance plans.

Princenthal advised men to consult with their primary care physician or urologist about prostate MR testing if they had a high, unexplained PSA test and at least one negative ultrasound-guided biopsy, or if they have been diagnosed with prostate cancer. Men already diagnosed can use the new MR testing to determine their cancer's size, location and aggressiveness to help determine the best treatment option, he said.

  © 2011 Scripps Newspaper Group — Online
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