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How Do You Diagnose Prostate Cancer

What To Expect During Cyberknife Treatment

Prostate cancer: how to detect, prevent and treat the disease

Before starting treatment, your doctor may use an imaging technique, such as a CT, MRI, or PET scan, to determine the tumors size, shape, and location. Depending on the location of the tumor, your doctor may implant small markers in or near the tumor to track its position during treatment sessions. Often, a customized soft face mask or body mold is created to minimize movement.

Our team works with you to ensure your comfort and safety throughout treatment. Patients are encouraged to wear comfortable clothing and to remove any jewelry. During treatment, the CyberKnife® robot delivers radiation by moving slowly around you. The image-guided system takes X-rays during this time to ensure that the treatment is delivered accurately.

This outpatient procedure doesnt require anesthesia or any incisions. Most people experience minimal side effects and can resume normal activities at the end of each session.

Characteristics Of Prostate Cancer

Ninety-five percent of prostate cancers are adenocarcinomas. In approximately 4% of men with prostate cancer, the neoplasm has transitional cell morphology and is thought to arise from the urothelial lining of the prostatic urethra.

In rare cases, the tumor has a neuroendocrine morphology in such instances the neoplasm is believed to have arisen from the neuroendocrine stem cells that are normally present in the prostate or from aberrant differentiation programs during cell transformation.

Seventy percent of prostate cancers arise in the peripheral zone, 15-20% arise in the central zone, and 10-15% arise in the transition zone.

Biopsy During Surgery To Treat Prostate Cancer

If there is more than a very small chance that the cancer might have spread , the surgeon may remove lymph nodes in the pelvis during the same operation as the removal of the prostate, which is known as a radical prostatectomy .

The lymph nodes and the prostate are then sent to the lab to be looked at. The lab results are usually available several days after surgery.

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Psa Screening Blood Test

A Prostate-specific antigen is made by the cells of the prostate gland. PSA testing is a common method to test for prostate cancer. PSA is found in semen, with a small amount in the blood. Men without prostate cancer often have PSA levels under 4 nanograms per milliliter of blood. Elevated PSA level increases the likelihood of having prostate cancer .

The American Cancer Society reports that men with a total PSA level of between 4 and 10 have roughly a 1 in 4 chance of having prostate cancer. With a total PSA of over 10, the chance of having prostate cancer rises to over 50%. Following the PSA test, if the levels are high, a doctor may suggest a repeat screening test or a prostate biopsy.

In addition to prostate cancer, there are many other factors that can affect a mans PSA levels.

Reasons for a High PSA:

Reasons for a Low PSA:

Why Does Prostate Cancer Cause Death

The Ultimate Guide To Dealing With Prostate Cancer By A ...

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Psa Test For Prostate Cancer

The prostate gland makes a protein called prostate specific antigen . This protein helps to nourish sperm. Normally, only tiny amounts of it enter the bloodstream.

Cancer cells in the prostate interfere with proper functioning and can cause large amounts of PSA to enter the bloodstream. Therefore, when high levels of PSA are detected in the bloodstream, this may indicate cancer.

Early prostate cancer often has no symptoms. However, high PSA levels can occur five to 10 years before the onset of prostate cancer symptoms. In such circumstances, the PSA test can help to indicate the presence of cancer at an early stage.

Other tests are needed to confirm a diagnosis because an abnormal PSA test can be due to non-cancerous causes. Equally, it is possible for a man to have a normal PSA level when cancer is present.

Gene Mutations And Genetic Syndromes

Its thought that 10% of prostate cancers are related to inherited mutations for which testing is now available. The chance that a prostate cancer is hereditary is increased if at least three relatives have had prostate cancer.

Some genetic changes associated with prostate cancer include:

  • BRCA gene mutations: Both BRCA1 gene mutations and BRCA2 gene mutations carry an increased risk of prostate cancer. Its important to note that both of these mutation types may be associated with different cancers in different family members. So, for example, your doctor may be more concerned that you have one of these mutations if you have young female relatives who have had breast cancer and another family member who has had pancreatic cancer than if you have a few male relatives who had prostate cancer at a later age.
  • Lynch syndrome : This syndrome is caused by mutations in DNA mismatch repair genes and is associated more strongly with colorectal cancer.
  • RNASEL mutations: These mutations affect a tumor suppressor gene.
  • HOXB13 mutations: These mutations are uncommon and are associated with prostate cancer in younger men.

Gene mutations can be confusing. It is not usually the gene mutation itself that gives rise to cancer. Many of the genes associated with an increased risk of cancer are tumor suppressor genes.

Whether or not you have a family history of prostate cancer, its helpful to learn about hereditary cancer when looking at your risk of any type of cancer.

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How Does The Doctor Know I Have Prostate Cancer

Prostate cancer tends to grow slowly over many years. Most men with early prostate cancer dont have changes that they notice. Signs of prostate cancer most often show up later, as the cancer grows.

Some signs of prostate cancer are trouble peeing, blood in the pee , trouble getting an erection, and pain in the back, hips, ribs, or other bones.

If signs are pointing to prostate cancer, tests will be done. Most men will not need all of them, but here are some of the tests you may need:

PSA blood test: PSA is a protein thats made by the prostate gland and can be found in the blood. Prostate cancer can make PSA levels go up. Blood tests will be done to see what your PSA level is and how it changes over time.

Transrectal ultrasound : For this test, a small wand is put into your rectum. It gives off sound waves and picks up the echoes as they bounce off the prostate gland. The echoes are made into a picture on a computer screen.

MRI: This test uses radio waves and strong magnets to make detailed pictures of the body. MRI scans can be used to look at the prostate and can show if the cancer has spread outside the prostate to nearby organs.

Prostate biopsy: For a prostate biopsy, the doctor uses a long, hollow needle to take out small pieces of the prostate where the cancer might be. This is often done while using TRUS or MRI to look at the prostate. The prostate pieces are then checked for cancer cells. Ask the doctor what kind of biopsy you need and how its done.

What Is A Normal Psa Test Result

Tests to Diagnose and Monitor Prostate Cancer

There is no specific normal or abnormal level of PSA in the blood, and levels may vary over time in the same man. In the past, most doctors considered PSA levels of 4.0 ng/mL and lower as normal. Therefore, if a man had a PSA level above 4.0 ng/mL, doctors would often recommend a prostate biopsy to determine whether prostate cancer was present.

However, more recent studies have shown that some men with PSA levels below 4.0 ng/mL have prostate cancer and that many men with higher levels do not have prostate cancer . In addition, various factors can cause a mans PSA level to fluctuate. For example, a mans PSA level often rises if he has prostatitis or a urinary tract infection. Prostate biopsies and prostate surgery also increase PSA level. Conversely, some drugsincluding finasteride and dutasteride , which are used to treat BPHlower a mans PSA level. PSA level may also vary somewhat across testing laboratories.

Another complicating factor is that studies to establish the normal range of PSA levels have been conducted primarily in populations of White men. Although expert opinions vary, there is no clear consensus regarding the optimal PSA threshold for recommending a prostate biopsy for men of any racial or ethnic group.

In general, however, the higher a mans PSA level, the more likely it is that he has prostate cancer. Moreover, a continuous rise in a mans PSA level over time may also be a sign of prostate cancer.

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Other Factors That Influence Psa Levels

The PSA blood test alone cannot diagnose prostate cancer. It is possible, although rare, to have prostate cancer without raised PSA levels in the blood. A higher-than-normal PSA level doesnt automatically indicate prostate cancer either. A high PSA level is due to cancer in around one in three cases.

PSA levels can be raised by other factors, including:

  • , also known as benign prostatic enlargement .

For this reason, the PSA blood test isnt used in isolation when checking for prostate cancer.

Medical History And Physical Exam

If your doctor suspects you might have prostate cancer, he or she will ask you about any symptoms you are having, such as any urinary or sexual problems, and how long you have had them. You might also be asked about possible risk factors, including your family history.

Your doctor will also examine you. This might include a digital rectal exam , during which the doctor inserts a gloved, lubricated finger into your rectum to feel for any bumps or hard areas on the prostate that might be cancer. If you do have cancer, the DRE can sometimes help tell if its only on one side of the prostate, if its on both sides, or if its likely to have spread beyond the prostate to nearby tissues. Your doctor may also examine other areas of your body.

After the exam, your doctor might then order some tests.

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How Cancer Causes Death

Even though cancer can lead to death, its not necessarily cancer that causes someone to die. Causes of cancer deaths can include:

  • Organ failure due to the size and stress of a tumor
  • Complications during surgery
  • Organ rupture due to tumor size
  • Infection due to the immune systems ability to fight off illness while on cancer treatment

Since all the organs in our body connect one way or another, all it takes is for one to begin shutting down, and the rest may start to follow suit. In the end, the person with cancer passes away.

Depending on the type of cancer, the cause of death can vary. Here are some more details on how cancer can cause death.

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What Are The Prostate Cancer Symptoms I Need To Look Out For

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In its early stages, prostate cancer may not show any symptoms. Symptoms of early prostate cancer can include:

  • difficulty passing urine
  • a slow, interrupted flow of urine
  • frequent passing of urine, including at night
  • incontinence.

Symptoms associated with advanced prostate cancer include:

  • blood in urine
  • pain during urination
  • lower back or pelvic pain.

These symptoms are also found in men who may have benign prostatic hyperplasia , a common, non-cancerous enlargement of the prostate gland.

If you experience these symptoms, visit your doctor.

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Questions To Ask The Doctor

  • What treatment do you think is best for me?
  • Whats the goal of this treatment? Do you think it could cure the cancer?
  • Will treatment include surgery? If so, who will do the surgery?
  • What will the surgery be like?
  • Will I need other types of treatment, too?
  • Whats the goal of these treatments?
  • What side effects could I have from these treatments?
  • What can I do about side effects that I might have?
  • Is there a clinical trial that might be right for me?
  • What about special vitamins or diets that friends tell me about? How will I know if they are safe?
  • How soon do I need to start treatment?
  • What should I do to be ready for treatment?
  • Is there anything I can do to help the treatment work better?
  • Whats the next step?

The Top 7 Signs Of Advanced Prostate Cancer

In the early stages, you may not notice any symptoms related to prostate cancer. This is why screenings are important. Symptoms can sometimes be noticed for the first time when the cancer advances.

Advanced prostate cancer, also called metastatic cancer, means the cancer has spread to other areas of your body beyond your prostate gland. The most common areas for prostate cancer to spread are your bladder, rectum, and bones. It can also spread to your lymph nodes, liver, lungs, and other body tissues.

Whether youve just been diagnosed or youre in treatment, its also important to know the signs of advanced cancer. Cancer can behave differently depending on your genetics, so not every person will experience the same symptoms in the same way.

Read on to learn more about the seven top symptoms of advanced prostate cancer and how to spot them.

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After Cancer Is Diagnosed

If the biopsy and other tests show that you have cancer, you may have more tests to help your doctor plan treatment. For instance, your doctor will need to figure out the stage of your cancer. For some cancers, knowing the grade of the tumor or risk group that you fall into are important for deciding on the best treatment. Your tumor may also be tested further for other tumor or genetic.

To learn more about other tests that may be used to plan treatment for your cancer, see the PDQ® cancer treatment summaries for adult and childhood cancers for your type of cancer.

Prostate Cancer: Advancements In Screenings

How do you diagnose Prostate Cancer?

Reviewed By:

Dr. Christian Paul Pavlovich

You may know thatprostate canceris one of the most common cancer types in men. The good news is that thereare many treatment and management options, even if the cancer is caught ata later stage.

What you may not know: There are several options when it comes toprostate cancer screening. After considering multiple factors, your doctor may recommend theprostate-specific antigen test, and/or one of the newer screeningtests that are now available.

Johns Hopkins urologistChristian Pavlovich, M.D., explains what you should know.

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Local Signs And Symptoms

In the pre-PSA era, patients with prostate cancer commonly presented with local symptoms. Urinary retention developed in 20-25% of these patients, back or leg pain developed in 20-40%, and hematuria developed in 10-15%. Currently, with PSA screening, 47% of cases are diagnosed in asymptomatic patients. In symptomatic patients, the most common complaints are urinary frequency , decreased urine stream , urinary urgency , and hematuria . However, none of these symptoms is unique to prostate cancer each can arise from various other ailments.

How Do I Get Tested

A general practitioner or an urologist can perform a full prostate cancer exam. This would usually include a PSA blood test and digital rectal exam, also called a DRE.

A Prostate Specific Antigen test measures the level of PSA in the blood. PSA is a substance made by the prostate. The levels of PSA in the blood can be higher in men who have prostate cancer. The PSA level may also be elevated in other conditions.

A Digital Rectal Exam is a test that is done when a doctor or nurse inserts a gloved, lubricated finger into the rectum to estimate the size of the prostate and feel for lumps or other abnormalities.

Talk to your general doctor or urologist about receiving a prostate exam. If you do not have a doctor, do not have insurance, and cannot afford a test, find out what free screenings are available in your area on our Free Testing Map. If you do not see a free screening in your area, check back in the fall. Many screenings occur in September, during Prostate Cancer Awareness Month.

Recent research has yielded additional tests that in addition to the PSA and subsequent DRE and Biopsy that can give a doctor more information on to determine the probability of both finding cancer during a biopsy and determining how aggressive that cancer is likely to be. Learn more here.

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