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Prognosis Positive


10 Image Is Everything
While prostate cancer is one of the most common cancers, it's also one of the most curable if caught early. Once it's been detected, the key is getting a good read on exactly how far along the cancer is and picking the right treatment. The treatment a patient receives -- from drugs to radiation and surgery -- has always been based largely on educated guesswork. That's changing.

For several years, Memorial Sloan-Kettering has been one of only two hospitals in the country working with magnetic resonance spectroscopy, a new technology that not only displays physical images of the prostate (with a garden-variety MRI) but also provides more detailed information about the exact location of the tumor as well as key data about its chemical makeup that tell the doctor how aggressive the tumor has become.

So how does this help? Well, for one, a radiologist can now target the tumor with far more accuracy and can apply appropriate doses based on the tumor's position and chemical makeup. And if surgery is necessary, it gives surgeons a road map to the tumor's precise location, making the surgery less exploratory.

The technology has been tested on nearly 400 patients at Sloan-Kettering alone. So far, the biggest beneficiaries are patients with early-stage cancer that is highly curable. That's because they have pretty clear choices of treatment. "If it's very curable," explains Dr. Jason Koutcher, "you go for the money -- either the surgery or the radiation."

Dr. Hedvig Hricak, the chair of radiology for Sloan-Kettering, expects that FDA approval for the new software and procedure will likely come later this year, with a wide distribution of the technology, which is being developed and manufactured by General Electric, within a year or so. "We are moving away from looking at anatomy only, and now we are looking at the anatomy and function," she says. "And that has been the biggest step forward in our ability to assess the disease."


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