The Best Test for Prostate Cancer

Assessing and testing for prostate cancer requires a comprehensive evaluation by healthcare professionals experienced in prostate cancer diagnosis. They will consider the results of the various assessments and work with you to develop an individualised treatment plan based on your specific situation. Prostate cancer tests typically involve a combination of medical history review, physical examination, and diagnostics. Here are the current gold-standard assessments for prostate cancer:

Prostate Cancer Diagnosis at Nottingham City Hospital
Nottingham City Hospital

Medical history review

Your healthcare provider will ask about your medical history, including any symptoms you may be experiencing, previous medical conditions and family history of prostate or other cancers.

Digital rectal examination (DRE)

During a DRE, a healthcare provider inserts a gloved, lubricated finger into the rectum to feel the prostate gland for any abnormalities, such as lumps, enlargement, or irregularities.

Prostate-specific antigen (PSA) blood test

PSA is a protein produced by the prostate gland. Elevated levels of PSA in the blood can indicate prostate abnormalities, including cancer. A PSA blood test can help detect prostate cancer or monitor its progression. However, it is important to note that an elevated PSA level does not necessarily mean prostate cancer is present, as other conditions can also cause elevated PSA levels. Also, note that some drugs such as Finasteride, a drug commonly taken for male pattern baldness can also lower the default PSA level.

Prostate biopsy

If there are suspicious findings during a DRE or elevated PSA levels, a prostate biopsy may be recommended. During a biopsy, small tissue samples are taken from the prostate gland using a thin needle. These samples are then examined under a microscope to determine if cancer cells are present and to assess the aggressiveness of the cancer.

Imaging tests

Imaging investigations, such as transrectal ultrasound (TRUS), magnetic resonance imaging (MRI), or computed tomography (CT scans), may be used to provide detailed images of the prostate and surrounding tissues. These tests can help determine the extent of the cancer and whether it has spread beyond the prostate.

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Gleason score

If prostate cancer is diagnosed, a pathologist will assign a Gleason score to the cancer cells based on their appearance under a microscope. The Gleason score helps determine the aggressiveness of the cancer and guides treatment decisions.

Disease Staging

Staging is the process of determining the extent of cancer’s spread. It involves imaging tests, such as bone scans or positron emission tomography (PET) scans, to evaluate if the cancer has spread to other parts of the body, such as bones or lymph nodes. Staging helps determine the appropriate treatment approach.

Assessing prostate cancer requires a comprehensive evaluation by healthcare professionals experienced in prostate cancer diagnosis and management. They will consider the results of the various assessments and work with you to develop an individualised treatment plan based on your specific situation.

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How to Know if your Prostate Cancer has Spread?

Determining whether prostate cancer has spread beyond the prostate gland involves a combination of diagnostic tests. Here are some common methods used to assess if prostate cancer has spread;

Various imaging tests can help detect if prostate cancer has spread to other parts of the body. These may include:

A bone scan can detect cancerous areas in the bones. A small amount of radioactive material is injected into a vein, and a special camera is used to detect the radiation and create images of the bones.

A CT scan uses X-rays to create detailed cross-sectional images of the body. It can help identify the presence of tumours in nearby lymph nodes or other organs.

An MRI exam uses powerful magnets and radio waves to produce detailed images of the prostate and surrounding tissues. It can provide information about the extent of cancer within the prostate gland and nearby structures.

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A PET scans involve injecting a small amount of radioactive material into the body. Cancer cells absorb the radioactive material, which can be detected by a special camera. PET scans combined with specific tracers, such as fluorodeoxyglucose can help detect metastases in lymph nodes, bones, or other distant organs.

If imaging tests suggest the possibility of cancer spread, a template or TRUS biopsy may be performed on suspicious areas. This involves collecting tissue samples from the suspected metastatic sites to determine if they contain cancer cells.

Monitoring PSA levels over time can provide information about the progression of prostate cancer. A significant rise in PSA levels after initial treatment or a continuous increase over time may indicate the spread of cancer to other parts of the body.

Symptoms experienced by the individual, such as bone pain, unexplained weight loss, fatigue, or difficulty urinating, can also provide clues about potential cancer spread. However, it’s important to note that these symptoms can be caused by various other conditions as well.

The assessment of whether prostate cancer has spread requires a comprehensive evaluation by healthcare professionals experienced in prostate cancer diagnosis and management. They will consider the results of imaging tests, biopsy findings, PSA levels, DRE’s and clinical symptoms to determine the extent of cancer spread. This information dictates treatment options and helps develop an appropriate management plan.

The TWO Best Ways to Monitor Prostate Cancer

Monitoring prostate cancer involves regular tests and assessments to track the progression of the disease and determine the need for treatment. Here are two common methods used to monitor prostate cancer:

PSA testing involves measuring the level of prostate-specific antigen, a protein produced by the prostate gland, in the blood. PSA levels may indicate the presence and progression of prostate cancer. Regular. A rising PSA level over time may indicate the need for further evaluation, such as a prostate biopsy or additional imaging tests and rectal examinations. Your consultant will discuss the frequency of tests.

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Active surveillance is a managed approach for low-risk localised prostate cancer. It involves close monitoring of the cancer with regular PSA tests, digital rectal exams, and possibly repeat biopsies. Treatment is deferred unless there are signs of disease progression, such as a significant increase in PSA levels or change in biopsy results.

Active surveillance allows individuals to avoid unnecessary treatment and its potential side effects, while keeping a close eye on the cancer to detect any changes that may require intervention. It should be noted that sometimes a change in “mind set” is needed as there is a feeling that “nothing is being done;” far from the truth!

It’s important to note that the choice of monitoring methods depends on the individual’s specific situation, including the stage and aggressiveness of the cancer, and should be discussed with a healthcare professional. Other monitoring methods, such as imaging tests (e.g., MRI or CT scans) or periodic biopsies, may also be used depending on the specific circumstances. Regular follow-up appointments with your healthcare provider are essential to ensure appropriate monitoring and timely intervention if needed.

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