Prostate Talk » diagnosing prostate cancer

How is prostate cancer diagnosed?

megdilts — Sun, 10 May 2009 22:40:48 +0000

A diagnosis of prostate cancer can be confirmed only by biopsy. During a biopsy, a urologist (a doctor who specializes in diseases of urinary and sex organs in men, and urinary organs in women) removes tissue samples, usually with a needle. This is generally done in the doctor’s office with local anesthesia. Then, a pathologist (a doctor who identifies diseases by studying tissues under a microscope) checks for cancer cells.

Men may have blood tests to see if the cancer has spread. Some men also may need the following imaging tests:

* Bone scan: A doctor injects a small amount of a radioactive substance into a blood vessel, and it travels through the bloodstream and collects in the bones. A machine called a scanner detects and measures the radiation. The scanner makes pictures of the bones on a computer screen or on film. The pictures may show cancer that has spread to the bones.

* Computerized tomography (CT) scan: An x-ray machine linked to a computer takes a series of detailed pictures of areas inside the body. Doctors often use CT scans to see the pelvis or abdomen.

* Magnetic resonance imaging (MRI): A strong magnet linked to a computer is used to make detailed pictures of areas inside the body.

Prostate cancer is described by both grade and stage.

* Grade describes how closely the tumor resembles normal glandular tissue of the prostate. Based on the microscopic appearance of the tumor tissue, pathologists may describe it as low-, medium-, or high-grade cancer. One way of grading prostate cancer, called the Gleason system, uses scores of 2 to 10. Another system uses G1 through G4. In both systems, the higher the score, the higher the grade of the tumor. High-grade tumors generally grow more quickly and are more likely to spread than low-grade tumors.

* Stage refers to the extent of the cancer. Early prostate cancer, stages I and II, is localized. It has not spread outside the prostate gland. Stage III prostate cancer, often called locally advanced disease, extends outside the gland and may be in the seminal vesicles. Stage IV means the cancer has spread beyond the seminal vesicles to lymph nodes and/or to other tissues or organs.

Source: the National Cancer Institute

Does prostate cancer screening save lives?

megdilts — Sun, 10 May 2009 22:39:42 +0000

The benefits of screening and local therapy (surgery or radiation therapy) for early prostate cancer remain unclear, and it is not known for certain whether prostate cancer screening saves lives. Because of this uncertainty, NCI, which is part of the National Institutes of Health, is supporting research to learn more about screening for prostate cancer. Currently, researchers are conducting a large randomized clinical trial, called the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, to determine whether screening with PSA tests and DREs reduces the death rate from this disease. The researchers are also assessing the risks of screening. Specifically, men who have an elevated PSA level or a suspicious DRE are more likely to have a biopsy, which is an invasive procedure, and, if the biopsy is positive, the risks of surgery, radiation therapy, and even active surveillance (also called watchful waiting) must be taken into account.

Source: the National Cancer Institute

How reliable are the screening tests for prostate cancer?

megdilts — Sat, 09 May 2009 22:51:51 +0000

Neither of the screening tests for prostate cancer is perfect. Most men with an elevated PSA level do not have prostate cancer (false positives), and some men with prostate cancer have a low PSA level (false negatives). The DRE is also associated with false positives and false negatives. Using the DRE and PSA together will miss fewer cancers (greater sensitivity) but also increases the number of false positives and subsequent biopsies in men without cancer (lower specificity).

The National Cancer Institute’s (NCI) Early Detection Research Network (EDRN) has a Prostate Collaborative Group that is exploring a variety of strategies to find better ways to detect prostate cancer early. In addition, NCI’s prostate cancer Specialized Program of Research Excellence (SPORE) is funding projects to identify new diagnostic and prognostic biological markers, or biomarkers, of prostate cancer besides PSA.

Source: the National Cancer Institute

Diagnosing Prostate Cancer

admin — Tue, 21 Apr 2009 18:57:56 +0000

Early prostate cancer often does not cause symptoms. As the cancer grows, you may have trouble urinating. You may need to urinate often, especially at night. Some men have pain or burning during urination, blood in the urine or semen, pain in the back, hips, or pelvis, and painful ejaculation.

To find out if these symptoms are caused by prostate cancer, your doctor will ask about your past medical problems. He or she will perform a physical exam. In the exam, your doctor will put a gloved finger into your rectum to feel your prostate for hard or lumpy areas.

Your doctor may also do a blood test to check the prostate-specific antigen (PSA) level. PSA levels may be high in men who have an enlarged prostate gland or prostate cancer. You may also need an ultrasound exam that takes computer pictures of the prostate.

If tests show that you might have cancer, your doctor will likely want to confirm this with a biopsy. He or she will take out tiny pieces of the prostate to look for cancer cells. Your doctor may want to do a biopsy again to check results.

Source: National Institute on Aging
U.S. Department of Health and Human Services