An accurate diagnosis is very important to distinguish
between prostate cancer and other prostate problems. The basic tests that
must be done are the digital rectal exam (DRE), a bladder and prostate
ultrasound, and a blood test to detect levels of PSA (Prostate Specific
Antigen) - a protein produced by the prostate. Elevated levels of PSA
may indicate a prostate abnormality. If the DRE or PSA tests are abnormal,
further studies may be conducted such as a diagnostic ultrasound procedure
called TRUS (Trans Rectal Ultra Sound), biopsy, CT scan, MRI scan or Bone
Scan.
The American Urological Association designed a score that helps to know
the level of difficulty to urinate considering the most important symptoms
presented in the enlargement of the prostate: frequency to urinate, changes
in the urine flow, night time urination and changes in the quality of
life Click
here for a prostate symptoms self-assessment
Tests that examine the prostate
and blood are used to detect (find) and diagnose prostate cancer
The following tests and procedures may be used:
- Digital rectal exam (DRE): An exam of the rectum. The doctor inserts
a lubricated, gloved finger into the rectum and feels the prostate
through the rectal wall for lumps or abnormal areas.
- Prostate-specific antigen (PSA) test: A test that measures the level
of PSA in the blood. PSA is a substance made by the prostate that
may be found in an increased amount in the blood of men who have prostate
cancer. PSA levels may also be high in men who have an infection or
inflammation of the prostate or BPH (an enlarged, but noncancerous,
prostate).
- Transrectal ultrasound: A procedure in which a probe that is about
the size of a finger is inserted into the rectum to check the prostate.
The probe is used to bounce high-energy sound waves (ultrasound) off
internal tissues or organs and make echoes. The echoes form a picture
of body tissues called a sonogram. Transrectal ultrasound is used
during a biopsy procedure.
- Biopsy: The removal of cells or tissues so they can be viewed under
a microscope by a pathologist. The pathologist will examine the biopsy
sample to check for cancer cells and determine the Gleason score.
The Gleason score ranges from 2-10 and describes how likely it is
that a tumor will spread. The lower the number, the less likely the
tumor is to spread. There are 2 types of biopsy procedures used to
diagnose prostate cancer:
::Transrectal biopsy: The removal of tissue from the prostate by inserting
a thin needle through the rectum and into the prostate. This procedure
is usually done using transrectal ultrasound to help guide the needle.
A pathologist views the tissue under a microscope to look for cancer
cells.
::Transperineal biopsy: The removal of tissue from the prostate by
inserting a thin needle through the skin between the scrotum and rectum
and into the prostate. A pathologist views the tissue under a microscope
to look for cancer cells.
Certain factors affect prognosis (chance of recovery)
and treatment options.
The prognosis (chance of recovery) and treatment options
depend on the following:
- The stage of the cancer (whether it affects part
of the prostate, involves the whole prostate, or has spread to other
places in the body).
- The patient’s age and health.
- Whether the cancer has just been diagnosed or
has recurred (come back).
Prognosis also depends on the Gleason score and
the level of PSA.
Prostate disease
treatment options
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