Imaging Tests For Prostate Cancer
Imaging tests use x-rays, magnetic fields, sound waves, or radioactive substances to create pictures of the inside of your body. One or more imaging tests might be used:
- To look for cancer in the prostate
- To help the doctor see the prostate during certain procedures
- To look for spread of prostate cancer to other parts of the body
Which tests you might need will depend on the situation. For example, a prostate biopsy is typically done with transrectal ultrasound and/or MRI to help guide the biopsy. If you are found to have prostate cancer, you might need imaging tests of other parts of your body to look for possible cancer spread.
The imaging tests used most often to look for prostate cancer spread include:
What Are Additional Tests For Detecting Prostate Problems
If the DRE or the PSA blood test indicates a problem may exist, the health care provider may order additional tests, including urinalysis, urodynamic tests, cystoscopy, abdominal ultrasound, transrectal ultrasound with prostate biopsy, and imaging studies such as magnetic resonance imaging or computerized tomography scan.
Medication For Urinary Problems
Your doctor may suggest various medications to help ease your urinary problems, including:
- medications to reduce the tone of the muscles of the urethra and prostate to minimise any constriction to urine flow caused when these muscles contract
- medication to reduce the size of the prostate gland. These medications work by blocking the action of male hormones produced by the prostate gland
- medications to relax the bladder, making unwanted contractions less likely and reducing the symptoms of urgency and frequency of urination
- the over-the-counter preparation saw palmetto is sometimes used. This may help some men, especially if frequent urination at night is a problem.
However, recent reviews of the evidence for using saw palmetto as a treatment for mild or moderate urinary symptoms did not show any improvement, compared to no treatment, in men with BPH.
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Do I Need The Psa Test
The PSA test is not recommended for men who dont have symptoms of prostate cancer, as it can lead to unnecessary investigations and treatments that have serious side effects.
If you are at higher risk of developing prostate cancer, or if you have symptoms that may indicate cancer, PSA testing may be of more benefit.
Cancer Council Australia and the Royal Australian College of General Practitioners both recommend against routine screening in men without symptoms. That is because the PSA test is not very accurate for screening men without symptoms. High PSA levels can be due to many things, and cancer is just one of them. And a man with prostate cancer can have a normal PSA level.
As there is a range of risks and potential benefits of PSA testing, talk to your doctor to help make an informed decision.
How Soon Will Prostate Test Results Be Available
Results for simple medical tests such as some urodynamic tests, cystoscopy, and abdominal ultrasound are often available soon after the test. The results of other medical tests such as PSA blood test and prostate tissue biopsy may take several days to come back. A health care provider will talk with the patient about the results and possible treatments for the problem.
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Further Tests For Prostate Cancer
If results of the PSA test or the DRE are abnormal, a urologist will likely recommend a biopsy, where small samples of tissue are removed from the prostate and examined.
If cancer is diagnosed, other tests may be used to check the progression of the cancer, including:
- magnetic resonance imaging scan of the prostate – often done before a biopsy
- bone scan – to check whether or not cancer cells have spread to the bones
- computed tomography scan – a specialised x-ray
- pelvic lymph node dissection – a nearby lymph node is removed and examined to check whether or not cancer cells have entered the lymphatic system .
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- The prostate gland is a male reproductive organ that produces fluids to feed and protect sperm cells.
- Many men experience urinary changes as they age. In many cases, these changes do not need specific treatment.
- When urinary changes cause problems, they can be treated successfully by lifestyle changes, medication, surgery or a combination of the three.
- For problems such as blood in the urine, pain on urination, inability to urinate or uncontrollable urine flow, see your doctor promptly.
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What Are Some Of The Limitations And Potential Harms Of The Psa Test For Prostate Cancer Screening
Detecting prostate cancer early may not reduce the chance of dying from prostate cancer. When used in screening, the PSA test can help detect small tumors that do not cause symptoms. Finding a small tumor, however, may not necessarily reduce a mans chance of dying from prostate cancer. Many tumors found through PSA testing grow so slowly that they are unlikely to threaten a mans life. Detecting tumors that are not life-threatening
that requires treatment.
Special Types Of Psa Tests
The PSA level from a screening test is sometimes referred to as total PSA, because it includes the different forms of PSA . If you decide to get a PSA screening test and the result isnt normal, some doctors might consider using different types of PSA tests to help decide if you need a prostate biopsy, although not all doctors agree on how to use these tests. If your PSA test result isnt normal, ask your doctor to discuss your cancer risk and your need for further tests.
Percent-free PSA: PSA occurs in 2 major forms in the blood. One form is attached to blood proteins, while the other circulates free . The percent-free PSA is the ratio of how much PSA circulates free compared to the total PSA level. The percentage of free PSA is lower in men who have prostate cancer than in men who do not.
If your PSA test result is in the borderline range , the percent-free PSA might be used to help decide if you should have a prostate biopsy. A lower percent-free PSA means that your chance of having prostate cancer is higher and you should probably have a biopsy.
Many doctors recommend a prostate biopsy for men whose percent-free PSA is 10% or less, and advise that men consider a biopsy if it is between 10% and 25%. Using these cutoffs detects most cancers and helps some men avoid unnecessary biopsies. This test is widely used, but not all doctors agree that 25% is the best cutoff point to decide on a biopsy, and the cutoff may change depending on the overall PSA level.
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Ejaculation Is A Potential Cause Of Mildly Elevated Psa
Ejaculation can cause a mild elevation of your PSA level, and so can having a digital rectal exam, says Milner. These types of PSA elevations are usually not enough to make a significant difference unless your PSA is borderline. PSA should return to normal in two to three days.
To avoid this type of elevation, doctors will usually draw blood for a persons PSA level before doing a rectal exam. Ask your doctor if you should avoid ejaculation for a few days before a PSA test.
If Screening Test Results Arent Normal
If you are screened for prostate cancer and your initial blood PSA level is higher than normal, it doesnt always mean that you have prostate cancer. Many men with higher than normal PSA levels do not have cancer. Still, further testing will be needed to help find out what is going on. Your doctor may advise one of these options:
- Waiting a while and having a second PSA test
- Getting another type of test to get a better idea of if you might have cancer
- Getting a prostate biopsy to find out if you have cancer
Its important to discuss your options, including their possible pros and cons, with your doctor to help you choose one you are comfortable with. Factors that might affect which option is best for you include:
- Your age and overall health
- The likelihood that you have prostate cancer
- Your own comfort level with waiting or getting further tests
If your initial PSA test was ordered by your primary care provider, you may be referred to a urologist for this discussion or for further testing.
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Diagnosing Chronic Bacterial Prostatitis
Your doctor will also perform a digital rectal exam to examine the prostate. During this test, they will insert a lubricated and gloved finger into your rectum to look for signs of infection, such as a soft or enlarged prostate.
Your doctor may also use the following tests and techniques:
Antibiotics are the main course of treatment for this condition. Theyre usually taken for 4 to 12 weeks. For many people, treatment will last for 6 weeks.
First-line treatment is typically a fluoroquinolone antibiotic, such as ciprofloxacin , ofloxacin, or levofloxacin.
However, fluoroquinolones can increase your risk for a ruptured Achilles tendon, which is why they are no longer considered a preferred treatment.
Other commonly prescribed antibiotics include:
- sulfamethoxazole/trimethoprim , another first-line treatment
- tetracycline antibiotics, such as doxycycline or azithromycin
Tetracyclines are commonly used in cases where a doctor identifies or suspects chlamydia or mycoplasma genitalium. Like chlamydia, mycoplasma genitalium is an STI.
The antibiotic that youre prescribed will ultimately depend on which bacterium is causing your prostatitis.
What If My Psa Is High
PSA screening is just the first step, alerting you and your doctor that more testing may be needed. If PSA is only slightly elevated, your doctor may recommend repeating the test a couple of weeks later. From there, other types of tests can help with the decision on whether you need a biopsy, including:
- Digital rectal exam , if not already done
- Free PSA test
- PSA velocity, or the rate of rise over time
- PSA density, or the PSA per volume of prostate
- PSA-based markers
- Other markers, a urinary PCA3 or SelectMDx test
- Magnetic resonance imaging of the prostate
Each time you see your doctor for a checkup, have a conversation about prostate health and prostate cancer screening. PCF recommends that you make a about PSA screening with your doctor, starting at age 45, or age 40 if you have a family history of prostate or other cancers or are Black.
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What If My Test Results Are Abnormal
If the results of early detection tests like the PSA test or the digital rectal exam suggest that you might have prostate cancer, your doctor will conduct further testing. The PSA may be repeated, or you may be sent to a specialist for more tests such as a transrectal ultrasound and a prostate biopsy.
In a prostate biopsy, a tissue sample is taken from your prostate. Cancer can only be diagnosed with a tissue sample.
In addition to a PSA test, DRE , and a biopsy, research has yielded additional tests that can detect if cancer is present, and if so, how aggressive that cancer might be:
- The Prostate Health Index combines three blood tests that give a more accurate Phi Score, which gives accurate information based on a high PSA to better determine the probability of finding cancer during a biopsy.
How Often Should Men Have A Prostate Screening
A prostate screening is extremely important to have regularly. Because, without them, a mans health is at a high risk of developing prostate cancer. Knowing how often prostate screenings should be had can be helpful to those men who are not sure.
A mans health is just as important to maintain as a womans. But most people are under the assumption that womens health needs more attention. However, that is not true. Men are at risk of developing prostate cancer, and it can become very problematic if not addressed.
Keep reading to find out how often a man should have a prostate screening.
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What Is A Prostate Screening
A prostate screening should be done routinely once a man turns a certain age. This in order to detect undiagnosed prostate cancer in someone who may not have any symptoms. There are two main tests that a man must undergo during a prostate screening: A PSA test and digital rectal exam. The PSA test checks the level of prostate-specific antigen in the blood. The digital rectal exam consists of the doctor feeling for any abnormalities within a mans prostate.
Both types of prostate screening tests are important to have because they test for different things. This means that complete confidence regarding the state of your prostate health requires both tests. As the most common cancer for men, it can be detected early and treated.
Screening For Prostate Cancer
Prostate cancer is typically treatable if caught early. More than 90 percent of prostate cancers are found when the disease is in the beginning stages, confined to the prostate and nearby organs.
Unlike screenings for breast and colon cancers, there are no universal screening guidelines for prostate cancer. The U.S. Preventive Services Task Force recommends that men age 55 to 69 weigh the benefits and risks before deciding whether they should undergo screening, which is typically performed with a blood test that measures levels of a protein called prostate-specific antigen .
However, men in high-risk groupssuch as those who are of African-American descent and/or have a first-degree relative diagnosed with prostate cancer before age 65should consider speaking with their doctor about starting screenings at an earlier age.
Men older than 70 shouldnt be routinely screened for prostate cancer, according to the USPSTF.
Regardless of age or risk factors, men should get checked if they suddenly experience issues with urination, erectile dysfunction or unexplained pain.
The USPSTF suggests that, before deciding on a screening, men should seek expert advice about the benefits and harms of screening. Risks may include:
- False positives
- Complications and side effects from biopsies to confirm a diagnosis
- The possibility that a prostate cancer diagnosis wont extend lifespan or improve quality of life
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When Do You Need A Prostate Exam
PSA is continuously present in the bloodstream for most men, and an increase in its number may be attributed to causes other than cancer. However, men who have an increased risk of prostate cancer should undergo a regular prostate exam.
Age, family history, and race are all possible factors that can increase your risk. Likewise, your doctor may also recommend that you undergo testing if you are experiencing discomfort or pain while urinating.
Symptoms which may indicate that you have a prostate issue include the following:
- Inconsistent flow of urine
How Often Is a Prostate Exam Necessary?
Your frequency of testing may be due to several factors, including your age and present health condition:
What Do The Results Mean
PSA levels may be above the baseline for various reasons other than prostate cancer.
Other factors that can raise PSA levels include:
- older age
- an enlarged prostate â because of benign prostatic hyperplasia , for example
- prostatitis, which is inflammation and swelling of the prostate
Also, people with obesity may have lower PSA readings.
In addition, some medications may reduce PSA levels, including:
- 5-alpha reductase inhibitors, which can help treat BPH
- aspirin, which some people take regularly as a blood thinner
- statins, which help manage cholesterol levels
- thiazide diuretics, a kind of water pill that can help reduce high blood pressure
Some herbal medicines and supplements can also lower PSA levels. Tell the doctor about any medications and supplements before undergoing the test.
High PSA levels alone do not indicate cancer. However, if a DRE also reveals changes, a doctor may recommend a biopsy for a more accurate result.
The PCA3 is another test for prostate cancer that doctors use in some circumstances. Find out more.
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What Is Benign Prostatic Hyperplasia
Benign prostatic hyperplasia , or benign prostatic hypertrophy, is an enlargement of the prostate, a walnut-sized gland that forms part of the male reproductive system. During ejaculation, the prostate secretes fluid into the urethra, the narrow tube that runs through the center of the prostate. When a man urinates, the bladder squeezes urine out through the urethra.
As a man ages, the prostate can become enlarged. Because it surrounds the urethra right at the bladder exit, the prostate may squeeze or pinch the urethra as it gets larger over time. This may cause difficulty with urination such as a slow stream, the need to strain, increased frequency, urgency to urinate, incomplete emptying of the bladder, and intermittent flow or dribbling.
BPH is the most common disorder of the prostate gland and the most common diagnosis by urologists for males between the ages of 45 and 74. More than half of men in their sixties and as many as 90 percent in their seventies and eighties have some symptoms of BPH.
Although research has yet to pinpoint a specific cause for BPH, theories focus on hormones and related substances like dihydrotestosterone , a testosterone derivative in the prostate that may encourage the growth of cells.