Prostate Cancer Diagnosis and Tests

Diagnosis of early prostate gland damage remains complicated. Early stages of prostate cancer course without symptoms and cancer may be found only after microscopic examination of prostate tissue which was removed for adenoma suspicion.

As a diagnostic marker is used prostate-specific antigen found in the blood plasma. False-positive results are not excluded, therefore are studied rates of antigen in the blood during one year, rates of bound and free antigens and age norms. Great significance has digital rectal examination.

Tumors which grow within prostate gland area are felt in form of typical nodes quite well. Unfortunately, only tenth part of cases may be treated because in pelvic lymph glands frequently are developed metastasis which cannot be found during digital rectal examination. Transrectal ultrasound of prostate helps to reveal cancer stage.

In most cases prostate cancer diagnosis is made at advanced stages. Frequently diagnosis is made for the second time during examination of patients who complain on bone pains. Thus when causes of such pains are examined, doctors find metastasis in bones. More than third of patients diagnosed with prostate cancer for the first time have invasion of cancer into nearby anatomical structures (neck of urinary bladder, seminal vesicles) which makes it impossible to use radical surgical treatment. Here laboratory tests show hyperactivity of acid phosphatase.

In patients with growths invasions into pelvic bones, lymph nodes, liver and lungs (in about 50% cases) acid phosphatase is 80% hyperactive. Activity of  acid phosphatase is examined before rectal examination and prostate massage (increase of this indicant in male blood may be observed for 1 – 2 days). For diagnosis confirmation is made needle biopsy of prostate.

Radioisotope scanning of bones and X-ray radiography help to find metastasis in bones. To find metastasis and cancer invasion in nearby organs are used computer tomography of pelvic area, intravenous pyelogram, X-ray examination.

To Treat Or Not Prostate Cancer

All the varieties of cancers are the second leading cause of death in men and women. Prostate cancer comes in second place for cancer-caused male deaths. Around 28,000 men die from it every year in the USA.

PSA, prostate specific antigen, is a blood test used for detection of prostate cancer. The problem with PSA is that it is sometimes high for reasons other than cancer, and it doesn't indicate the cancer's aggressiveness. Most prostate cancer cases are not lethal. Why, then, do so many men die from it? First of all, many men have it. Almost all men in their 80s have patches of prostate cancer in their gland and many men in their 70s have it. A large percentage of these men will live out their full life span without ever having a single prostate cancer symptom.

If a man could be assured that his prostate cancer would not be lethal, that man most likely would choose not to treat it. Treatment can come at a price. It can lead to erectile dysfunction, urine leakage and the complications of radiation, such as damage to the rectum. For these and other reasons, the United States Preventive Task Force recommends that men 75 years and older or men with a life expectancy of less than 10 years not be tested with PSA.

Not everyone agrees with these guidelines. Testing for prostate cancer at older ages is something best left to a well-informed patient and his doctor. Prostate problems effect a man's activities and all ages can be effected. Men often know a lot more about a womens cycle than they do about their own sexual health. Problems with a male prostate as just as common that with womens period cycle issues.

Some of the symptoms with men with prostate problems are difficulty in urination with increased frequency of urination. Painful urination and having to get up at night to urinate are other symptoms. Pain in the lower back is another sign of possible prostate problems.

Experts in diet recommend that a good diet and exercise routine help in preventive and treatment of prostate problems. General recommendations are to reduce red meat and saturated fat in the diet and eat more fruit and vegetables. Drinking more water rather that coke and a good exercise program are essential both for prostate care and leading a better, healthier and happier life.

Prostate-Specific Antigen (PSA) Test

Normally blood contains small amount of prostate-specific antigen (PSA). PSA is a specific protein produced by prostate gland in men. PSA increases in blood in case of prostate enlargement, prostate inflammation or other diseases. Also it increases in case of prostate cancer. Blood test detects the level of PSA. As other tests, here is possible false-positive and false-negative results. Sometimes in men diseased with prostate cancer this test shows negative result, but in men with high PSA level the horrible diagnosis is not confirmed.

For men older than 50 years is recommended to undergo digital rectal examination and PSA test. Men with bad inheritance should make examination at 45 years. As for this, there is an other opinion. Some specialists say there is not necessarily to examine every single man. You should discuss with your doctor the necessity of examination only in case when you are 50 years older or there was prostate cancer cases in your family. Because the advisability of test is quarreled, you should discuss with your doctor all its risks and advantages.

PSA test can be used to follow progress of a disease or to define the effectiveness of chosen treatment.

PSA test preparation

There is no necessary to make a special preparation for the test. To avoid false results it is better to perform PSA test exactly before digital rectal examination or in two days or more after it.

Test performance

To examine PSA they draw a blood sample from vein. When needle insertion you can feel pain but it feels not for a long time. A little dose of blood is taken in tube and it is sent into laboratories.

Duration of procedure

PSA blood sampling takes 3-5 minutes.

Bad result: what to do?

If PSA in blood is high, and when rectal examination anything suspicious was not detected, doctor can ask you to make test again.

PSA level higher than 4ng/ml means 20-25% probability of prostate cancer. If PSA level is higher than 10ng/ml then the probability of prostate cancer is 50%. The more higher PSA level is in blood the more higher is threat of oncological diseases.

However, the result of PSA test can be the evidence to establish diagnosis of cancer. PSA level can increase when innocent prostate hyperplasia. Besides that, it can increase because of infections, prostate inflammations, and also after biopsy and operations on prostate. If PSA level is above normal, it is necessary to undergo Transrectal Ultrasonography. To detect cancer it is necessary to make biopsy.

PSA test risks

PSA test itself is not connected with risk. False-positive result of this analysis makes patient undergo other examinations, and false-negative result complicates cancer diagnosis.

In majority of men over 40 years PSA level in their blood is below 4ng/ml. Men on the right side of 40 should have PSA level no more than 2.7 ng/ml.

Prostate Cancer Myths

Myth #1. Diseased with prostate cancer die but not from it

In fact, every sixth man diseases with prostate cancer, but dies of it only every thirty fifth man. There is possible to live with some forms of cancer for years, but do not forget that prostate cancer is a second oncologic male disease with fatal cases.

Myth #2. There is no need to undergo examination because doctors do quarrel about its effectiveness

In fact, the main aim of examination is to detect disease at early stages. There are two kinds of examinations: blood test on Prostate-Specific Antigen (PSA) and digital rectal examination. Doctors do not quarrel the necessity of both those examinations.

Prostate-Specific Antigen (PSA) normally is detected in blood in small amounts. The level of PSA usually raises when prostate cancer, and also when prostatitis and innocent hyperplasia of prostate. As most of analysis, PSA-test does not guarantee 100% diagnostic accuracy. In some cases invasive methods are used for examination (prostate biopsy).

On the other side, results of PSA can be normal even when prostate cancer. Since 1990, when PSA was introduced in clinical practice, mortality from prostate cancer is lowered. However, some doctors are not sure that PSA is the reason of that.

Quarrels about necessity of men health examination with PSA still take place. However, the examinations to detect prostate cancer are recommended for men over 50. If your nearest relatives (father, brother, uncle) were diseased with prostate cancer, you should start examinations at 45. Is it worth or not is a personal question.

Myth #3. After prostate removal a man becomes impotent

In fact, prostatectomy is a surgical procedure to remove prostate gland affected with cancer. Sometimes during this operation nerves controlling erection can be affected. After operation most of men face with such a problem as erectile dysfunction. How long problems will last depend on the man's age, erection before operation and on kind of surgical intervention.

The operation allowing to avoid nerves damage lowers risk of erectile dysfunction progress. If necessary, it is possible to keep erection by using penile injections and special devices.

Myth #4. Men after prostatectomy suffer from uroclepsia

The main side effect of prostatectomy is uroclepsia. In most men it occurs after several weeks or months after operation. According to statistics, in 5 years after surgical intercourse about 1/3 of men suffer from high-stress uroclepsia (urine leak when coughing, physical exercises, laughing or sneezing). Only in 5% of cases was registered a serious uroclepsia.

Risk of uroclepsia is lowered when the operation in performed in big oncologic centers under the supervision of qualified specialists.