PSA mystery solved at Upstate

Paul Kruger, who lives in Dexter, NY, works at Fort Drum, north and east of Watertown. He underwent five biopsies of his prostate before a physician at Upstate located the cancer that was causing his elevated prostate-specific antigen test.

Paul Kruger, who lives in Dexter, NY, works at Fort Drum, north and east of Watertown. He underwent five biopsies of his prostate before a physician at Upstate located the cancer that was causing his elevated prostate-specific antigen test.

By Susan Cole

The uncertainty and the waiting were the hardest parts of Paul Kruger’s battle with prostate cancer.

Kruger, 56. a heavy equipment mechanic at Fort Drum, knew an elevated prostate-specific antigen (PSA) level indicated trouble, but after five years of examinations and five painful biopsies, he was no closer to knowing why his level was so high. Then his wife, Nora read about the precision biopsies the urology team at Upstate University Hospital was using. The Krugers immediately booked an appointment.

Urologic oncologist, Srinivas Vourganti, MD, ordered a magnetic resonance imaging scan for Kruger, using a powerful 3 tesla machine. The MRI revealed areas of suspicion within the prostate and gave Vourganti some targets for the biopsy that would remove some cells for laboratory analysis. When the test results came back, Kruger learned that about a third of his prostate was taken over by cancer.

Hear an interview with Vourganti about the UroNav procedure

This red triangle is a 3-D image of Paul Kruger's prostate. The circular colored areas are areas of suspicion, as indicated by a magnetic resonance imaging scan. Using Upstate's UroNav fusion biopsy system, Srinivas Vourganti, MD, hones in on areas where cancer may be hiding. The cylinders show where the urologic oncologist removed tissue samples for biopsy. Cancer cells were found to occupy about a third of Kruger's prostate, in the green circular region.

This red triangle is a 3-D image of Paul Kruger’s prostate. The circular colored areas are areas of suspicion, as indicated by a magnetic resonance imaging scan. Using Upstate’s UroNav fusion biopsy system, Srinivas Vourganti, MD, hones in on areas where cancer may be hiding. The cylinders show where the urologic oncologist removed tissue samples for biopsy. Cancer cells were found to occupy about a third of Kruger’s prostate, in the green circular region.

The uncertainty over, he shifted his focus to cope with a cancer diagnosis. “All the waiting, not knowing and not understanding is what is hard,” he said. “Every time I went through another biopsy, I thought, ‘When are they going to find it?’ “

After Vourganti explained his options, Kruger decided to have his prostate surgically removed in a minimally invasive operation last June. Vourganti said the operation was a success. “Mr. Kruger’s tumor was well away from the erectile nerves, so I was able to perform a bilateral nerve-sparing surgery, “ he described.

Six months after the surgery, Kruger is cancer-free and back to his normal routine, keeping the snow plows running at Fort Drum.

He said he is grateful that his Upstate team worked so quickly and effectively to remove his cancer.

“We’ve had family members with cancer, and it was a death sentence, “ Kruger said. “To come to Upstate and meet Dr. Vourganti and have all my questions finally answered and my cancer gone? It’s amazing.”

What’s the PSA?

The PSA test measures the blood level of prostate-specific antigen, a protein that is produced by the prostate gland. The higher a man’s PSA level, the more likely it is that he had prostate cancer. However, there are additional reasons for having an elevated PSA level, and some men who have prostate cancer do not have elevated PSA.

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