Step I- Prostate Cancer Screening
Prostate cancer is known as a silent killer because it often lacks symptoms. That is why annual screening tests are recommended when a man reaches age 50, or earlier if he is at higher risk.
Initial screening for prostate cancer consists of a digital rectal exam (DRE) and a prostate specific antigen (PSA) test.
Related Articles:
- When Should I Be Tested?-- A quick rundown to answer the question of when a man should be screened for prostate cancer.
- Digital Rectal Exam (DRE)-- Describes the digital rectal exam (DRE), one of two tests used annually to screen for prostate cancer.
- Prostate Specific Antigen (PSA) Test-- Describes the PSA test used to screen for prostate cancer.
- Interpreting Prostate Specific Antigen (PSA) Test Results-- Describes the way PSA test results are interpreted by your health-care provider.
- What is A PSAII Test, and What Do the Results Mean?-- The PSA II test is now being used to more accurately determine if a man may have prostate cancer. What do the numbers mean, and how does a doctor use the results to determine what, if any action needs to be taken?
- Poll: Would You Give Your Doctor A Semen Sample to Test for Prostate Cancer? -- An unscientific poll about a semen-based prostate cancer screening test.
- Poll: Do You Follow the Prostate Cancer Screening Guidelines?-- Do you follow the prostate cancer screening guidelines? (A non-scientific poll)
A physician may also order a urine test if you are having symptoms in order to rule out those other prostate problems including BPH and prostatitis.
Further Evaluation-- Prostate Biopsy
If initial screening and examination suggest prostate cancer, your health-care professional may order a prostate biopsy. During a biopsy, small tissue samples are taken and analyzed at a lab to determine if cancer cells exist. To do a biopsy, the doctor inserts an ultrasound probe into your rectum as in the TRUS described above. Looking at images on the ultrasound monitor, the doctor looks for any suspicious areas. Small, hollow, spring-loaded needles are aimed at any suspicious areas and "fired" to retrieve small "cores" of suspicious tissue.
Eight or more "cores" are usually acquired and sent to a pathology lab. These cores are studied by a pathologist who specializes in diagnosing cancer and other tissue abnormalities. The pathologist can determine if the core samples contain cancer and estimate how aggressive any cancer may be.
If it is cancer, a doctor may recommend further testing to see how far the prostate cancer has spread or if it has spread. Many don't require further studies, especially if it's a type and size of cancer that has not yet spread to other tissues. These men can now be evaluated for treatment.
Determining the Extent of Prostate Cancer
If further testing is needed, one or several tests may be ordered.
These include:
- Bone scan-- A bone scan is an X-ray style running picture of your skeleton to help determine if the cancer has spread to the bones (prostate cancer often metastasizes to the bones).
- Ultrasound--
An ultrasound of the surrounding tissues may be performed to see if cancer may have spread to the nearby tissue.
- Lymph Node Biopsy--
When cancer spreads, it often goes through the nearby lymph nodes. The doctor may order a biopsy of those lymph nodes to look for cancer cells. During this procedure, one or several lymph nodes near your prostate may be removed and examined by a pathologist.
- Chest X-ray--
A chest X-ray may show if cancer has spread to your backbone, ribs, or lungs, common places for prostate cancer to spread.
- CT scan--
Often called a "cat scan," the CT (computerized tomography) scan takes cross-sectional X-rays of your body and uses a computer to make a three-dimensional image for your doctor to study. They can show swollen lymph nodes or abnormalities in organs, but cannot determine if cancer is the culprit for these abnormalities. That's why a CT is used in combination with other examinations.
- MRI (Magnetic Resonance Imaging)--
Something like a CT scan, the MRI takes cross-sectional pictures of your body and uses a computer to make a three-dimensional image. The MRI uses magnets and radio waves instead of the X-rays used by a CT. MRIs can help look for evidence of the spread of prostate cancer to other tissues.
