Patients Who Have Undergone Prostate Mapping
Patient 1
Pre-Prostate Mapping diagnosis
67 year old man. PSA 8.
Prostate cancer. Right side. Gleason 3+3=6. 1/8 biopsies positive.
Prostate Mapping
Multi-sequence MRI shows disease on both sides which is localised with no spread outside the gland.
Prostate Mapping biopsies show 5 out of 30 biopsies positive for cancer. Both areas were of higher risk, Gleason 3+4=7.
Change in management
Originally eligible for active surveillance or radical therapy.
Post-Prostate Mapping:
Originally eligible for active surveillance or radical therapy.
Post-Prostate Mapping:
- Recommended not to have active surveillance because of higher Gleason Grade.
- Cound have radiotherapy and surgery although nerve-sparing surgery may not be possible on left side of gland.
- Opted for focal therapy using HIFU. Erections returned after 2-3 months.
Patient 2
Pre-Prostate Mapping diagnosis
56 year old man. PSA 5.
Prostate cancer. left side. Gleason 3+3=6. 1/10 biopsies positive.
Prostate Mapping
Multi-sequence MRI shows disease on left side which is localised with no spread outside the gland.
Prostate Mapping biopsies confirm the tumour in the left side of the gland (red boxes),
but has also demonstrated a tumour in the right side (blue boxes) that MRI did
not detect. A biopsy has been taken for each small white dot - a coordinate - which
are spaced every 5mm. Each coordinate is designated a letter and a number
representing the 'x' and 'y' coordinates. So, in this example, cancer has been
found at coordinates D1.5, d1.5, E1.5, e1.5, D2.0, d2.0, E2.0, D2.5 and a
separate focus in coordinates C2.5, C3.0, c3.0. The area on the left (red dots)
is Gleason 3+4=7, whilst the area on the right (blue) is lower risk,
Gleason 3+3=6.
Change in management
Originally eligible for active surveillance or radical therapy.
Post-Prostate Mapping:
Change in management
Originally eligible for active surveillance or radical therapy.
Post-Prostate Mapping:
- Recommended not to have active surveillance because of higher Gleason Grade.
- Could have external beam radiotherapy with boost to left side or nerve-sparing surgery on right side.
- Opted for focal therapy using HIFU. Erections returned within 3 weeks after treatment.
