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How to avoid a biopsy to test for prostate cancer

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Since when is an MRI conclusive proof of cancer, surely a biopsy is the gold standard test?

Edited by chiang mai
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19 minutes ago, chiang mai said:

Since when is an MRI conclusive proof of cancer, surely a biopsy is the gold standard test?

I made my post (and link) in the hope it might benefit others. Not to enter a debate as to what can conclusively prove or not prove cancer.  I followed the advice of one of the top urologists in Thailand and he is confident the MRI is as far as humanly possible sufficiently conclusive.

Read the Daily Telegraph article which in effect supports my doctors advice.

If you are a prostate specialist then let us know your credentials.

Edited by R123
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Actually this reports says that MRI can be very effective in finding and rating the cancer as it covers the whole area rather than a biopsy which only gets cells from specific spots.  Obviously it would have to be read by an expert and if cancer found suspect biopsy might also be done prior to operation.  I know CT scans w/contrast are a standard check for cancer spread and MRI is even more detailed than most CT scans so appears to make sense to me (layman).  

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1 minute ago, R123 said:

I made my post (and link) in the hope it might benefit others. Not to enter a debate as to what can conclusively prove or not prove cancer.  I followed the advice of one of the top urologists in Thailand and he is confident the MRI is as far a humanly possibly sufficiently conclusive.

Read the Daily Telegraph article which in effect supports my doctors advice.

If you are a prostate specialist then let us know your credentials.

 

No need to be snotty, I simply asked the question, if you don't know you don't know!

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2 minutes ago, lopburi3 said:

Actually this reports says that MRI can be very effective in finding and rating the cancer as it covers the whole area rather than a biopsy which only gets cells from specific spots.  Obviously it would have to be read by an expert and if cancer found suspect biopsy might also be done prior to operation.  I know CT scans w/contrast are a standard check for cancer spread and MRI is even more detailed than most CT scans so appears to make sense to me (layman).  

 

And as a layman also, my understanding has always been that MRI (with contrast) is a useful diagnostic tool but that it's not definitive, the article posted seems to suggest a biopsy is used where the MRI shows a positive result hence my question earlier.

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Since when is an MRI conclusive proof of cancer, surely a biopsy is the gold standard test?


Oddly i was listening to my local radio here 30 mins ago which has a live feed connection to BBC World News and they had a report on a breakthrough by UK doctors published in The Lancet whereby they had used MRI to significantly improve discovery of prostate cancer so maybe new developments on the horizon.
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Oddly i was listening to my local radio here 30 mins ago which has a live feed connection to BBC World News and they had a report on a breakthrough by UK doctors published in The Lancet whereby they had used MRI to significantly improve discovery of prostate cancer so maybe new developments on the horizon.



Edit: oops - just noticed link in OP!

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27 minutes ago, chiang mai said:

Since when is an MRI conclusive proof of cancer, surely a biopsy is the gold standard test?

no, it's not! an MRI can rule out cancer, a biopsy cannot. no need for a biopsy if the MRI is "negative". but if cancer is detected an MRI cannot determine the kind, a pathological examination based on biopsies (always plural) can.

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So the MRI is the gold standard for detection whilst a biopsy remains the gold standard for identification, that makes sense.

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53 minutes ago, chiang mai said:

Since when is an MRI conclusive proof of cancer, surely a biopsy is the gold standard test?

This was in an English newspaper today stating that an MRI scan could replace biopsies, which can also cause problems themselves. What did the scan cost? 

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Can you name the "well respected doctor" at Bumrugrad?

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12 minutes ago, Spaniel said:

Can you name the "well respected doctor" at Bumrugrad?

Dr. Viroj Chodchoy at Bumrungrad   

 

And to address another poster my recollection was that the MRI cost was @ 40,000 baht; my insurance paid it.

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Well many views let me share some of my experiences

 

I had an MRI with dye into the bloodstream, and contrast separately up the anus last week at Chula Bangkok a top cancer hospital in Thailand, cost 10,500, a big difference from 40,000 from R123

 

In September 2015 I had an MRI in Khonkaen and it showed no prostate cancer or other cancer

 

In October 2015 CT scan in khonkaen, no prostate cancer identified, or other cancer

 

In September 2016 I had Holep surgery for prostate in India

 

Biopsy of material removed showed prostate cancer

 

The prostate surgeon in India told me a biopsy normally done on the prostate can still miss cancer as it is only a sample of twelve needle samples, and the needle can miss

 

I have also had annual medicals for the last ten years, and always been told no problem

 

Due to following my instinct I had another colonoscopy and discovered colon/rectum cancer

 

I am currently undergoing treatment for both prostate and colon/rectum cancer, and neither were found on either the first MRI or the CT scan

 

Draw you own conclusions

 

 

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I also question (without pejorative thoughts!) the accuracy of R123's recollection of a ThB 40k cost for an MRI with contrast scan. We all know Bumrungrad can be expensive but even so I had a CT scan with contrast on my chest there 8 months ago and the bill for the scan itself was ThB 13.2k or ThB 25.5k fully inclusive. I don't think an MRI would be that much more expensive than a CT .... would it?

 

 

 

[ Quoting scan costs on a comparative basis is fraught with difficulties. I have seen people boast that their local private hospital CT scan cost only Thb 8k. Depends what basis you are quoting. The reason why I show two different numbers above is to make that point. My Bum CT bill (paid for it myself as far as they knew, so some 'insurer-creep' may have elevated 123's bill) breaks out as follows:

  • CT scan 13.3k
  • Medicine (contrast dye I presume, as no other meds were given) 6.3k
  • Doctor's fee 2.0k*
  • CT scan radiologists fee 2.5k* ^
  • Nursing service/Facility/Laboratory Clinical/Others - all separately priced out on the bill - totalling 1.4k

*  Bum insist on a quick doctor talk and a radiologist's report - even if you tell them you are just 'buying a scan only' ie having it to send the disc to another  hospital's specialists - in this case my UK 's pulmonology specialists

^  I also asked to have a discussion on related matters with their immunologist, so the doctor's fee might have been as low as 0.6k had it just been about the scan  ]

Edited by SantiSuk
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BANGKOK 20 November 2017 22:33
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