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.

Prostate Cancer Diagnostic Methods

At early stages cancer shows no symptoms, therefore prostate cancer is difficult to detect.

Urologist must perform here digital rectal examination of prostate gland. This examination helps to detect induration of prostate and exclude cancerous growths.

Also are performed next examinations:

• identification of PSA rate in blood
• transrectal ultrasound
• biopsy of prostate gland

When prostate cancer is suspected, it is necessary to examine areas where lymph glands are located in order to find if they were affected by cancer or not.

Most important test in cancer diagnostics is PSA (prostate specific antigen) test. Today this test is major method of screening and early detection of prostate cancer.

Unfortunately, PSA is not specific for prostate cancer, its rate may be increased after sexual intercourse, in case of various inflammations in prostate, adenoma, and after various operations. However, often this is the only symptom which helps to suspect cancerous growths in prostate gland.

To exclude false-positive results, there do exist several methods to calculate PSA:
1) pace of PSA rate increase (increase by 0,75ng/ml and more each year may be an indication of prostate cancer)
2) age norms of PSA rate (PSA rate increases with aging as prostate gland increases in its size, however its rate must be no more than 4ng/ml at age of 50)
3) rates of free and connected PSA (correlation between these rates is most significant criteria of prostate cancer diagnostics)

Next stage in prostate cancer diagnostics after PSA test is transrectal ultrasound which shows size of prostate gland, indurations and nodular lumps. Transrectal ultrasound helps more precise than digital rectal examination to detect stage of prostate cancer.

Biopsy of prostate cancer is major method to confirm prostate cancer diagnosis. It is performed along with ultrasound examination. In biopsy is used special device which is inserted into rectum to take several (6 – 12) fragments of prostate gland. Then is performed microscopic examination to define types of cells. Fragments where nodular lumps were found are examined more carefully. In case biopsy showed negative result, but in the course of several months PSA rate is increased, then PSA test is made once again.

After diagnosis of prostate cancer is made computed tomography and magnetic resonance imaging (MRI) of pelvis organs, and also scanning of bones to detect metastasis.