24 April 2012

The validity of emerging diagnostic imaging techniques for prostate cancer such as functional magnetic resonance imaging (MRI) were challenged and closely examined at the 9th ESOU Meeting, with some experts pointing out the lack of validated studies on these imaging techniques.

“There is no ideal imaging techniques to detect early stage prostate cancer…and the routine use of an invalidated method does not meet scientific standards,” said Karl Pummer (AT) in his concluding remarks on the topic of innovations in diagnostic imaging.

Pummer said that although there are ongoing studies on techniques such as functional MRI and multiparametric MRI, these innovations still run short of sufficient and reliable data. He cautioned that overly promoting these techniques before the acquisition of sufficient data and evidence sends the wrong message to patients.

“Charging patients for invalidated methods does not meet ethical standards either,” said Pummer.

Pummer’s lecture prompted discussion during the Q&A forum which followed his lecture, with some participants saying that although caution should be exercised it would also be unproductive not to further look or closely investigate these emerging techniques.

“Definitely more studies and trials should be done, but at the same time we could not just ignore or neglect looking into these techniques,” commented Manfred Wirth during the open forum.

Other key messages during the initial session on prostate cancer were:

•On chemoprevention: “No evidence on micronutrients and supplements but there are some benefits shown on so-called Mediterranean diet, lycopene and likely potential benefits on 5alpha reductase inhibitors, NSAIDS, etc. (B. Schmitz-Drager)

•On negative biopsies: “Repeat biopsies are needed but we have to determine the level of suspicion, with PSA doubling time and nomogrammes.” (B. Djavan)

•On intermittent hormonal therapy as standard: “Intermittent androgen deprivation (IAD, on non-metastatic PCa cases) is currently widely offered in patients with PCa in various clinical settings, and its status should no longer be regarded as investigational.” (M. Wirth)

•On intermittent hormonal therapy: “It is not a standard but a good option in many cases …there is still a lot more to improve and investigate.” (A. Mendoza-Valdes)

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