Originally Posted by Trace212
His scans came back clean. What a relief that is!! His MD wants him to have an MRI though. It sounds like it is because he wants to determine the extent of the Cancer....
Congratulations to you and your husband on that great result!
Those results pretty much rule out the existence of large tumors, as I understand it.
While that wasn't likely, I would say it's champagne time for both of you!
I never had either type of MRI, but I see it the way daff does: it should be an endorectal MRI if practical. The book "A Primer on Prostate Cancer - The Empowered Patient's Guide," describes that scan on pages 57 and 58, including an image and graphic. Ideally, the scan would include sensing the spectrographic characteristics of each section of the image as well as the MRI characteristics.
As daff said, it is only available in a few places, but you are in luck: one of the most experienced sites is Memorial Sloan Kettering (MSK), probably just a few hours train ride away for your husband.
(Another site with long experience, also mentioned in the Primer along with MSK, is in San Francisco.)
Here's a little of what the Primer says about this scan (endorectal MRI with spectroscopy): "... This technique is far superior to a routine pelvic MRI and is associated with a 75% to 90% accuracy rate when there is agreement (concordance) between both spectroscopy and MRI modalities of imaging...."
(In other words, it achieves that high accuracy rate when the spectroscopy agrees with the MRI image.) Do you have the Primer? If not I could add more about that scan. The endorectal MRI with spectroscopy has been improving for years now, and probably the latest major improvement is a more powerful MRI, up to 3 Tesla power. Tesla is a measure of the strength of the magnetic field, and the higher the Tesla, the higher the resolution of the image. A problem for insitutions investing in this technology is that it costs about $1,000,000 per Tesla, so many sites apparently cannot justify the expense of 3 Tesla equipment. I would be surprised if Memorial Sloan Kettering did not have that capability.
Dr. Myers also discusses endo-rectal MRI in his book "Beating Prostate Cancer: Hormonal Therapy & Diet," around page 34 in my original edition. He notes its strengths in helping detect the extent of cancer within the prostate as well as penetration through the prostate capsule, but he also notes that it has difficulty distinguishing between cancer and previous bleeding from the biopsy. Dr. Myers states that regular CAT and MRI scans are widely used to detect lymph node involvement "but are completely inadequate."
The problem is that it take a pretty big tumor to show up on those scans, letting a lot of the smaller but significant tumors slip through undetected. "... Studies consistently show that these techniques only identify 15-30% of known lymph node metastases...."
There's a lot of information about results using the technology on PubMed, a site we can use here because it is Government sponsored: [url]www.pubmed.gov[/url]. I got 84 hits using this search string: " endorectal MRI with spectroscopy AND prostate cancer ". Dr. Jon Kurhanewicz at the U. of California, San Francisco is one of the world's leading authorities and is listed as a co-author and senior (last) author on a number of these papers. Some of the language is hard to plow through.
I don't know whether Yale or a center near to you would also have endorectal MRI capability, or endorectal MRI with spectroscopy. If it were my own case and I lived in Connecticut, I would want MSK to do it because of their long experience, unless someone more local also could demonstrate special expertise. Your sister could probably search out those facts. It's worth checking with your husband's doctor to see what kind of MRI he has in mind. If its just a conventional MRI, you might want to check with your sister to see if she sees any added value in doing that.
The Primer describes endorectal MRI as a 50 minute procedure. I've heard from a couple guys who have had it that it is not the most fun they have ever had in life, by a long shot!
They said it was hard mostly because you were conscious and were on the scanning table for a long time in not-so-comfortable circumstances. Daff, how did it go for you?