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Ways To Diagnose Prostate Cancer

Talk To Your Loved Ones

Making Decisions After Being Diagnosed with Early Stage Prostate Cancer | UCLAMDChat

An effective way of venting out your emotions is talking to someone.

Having the assurance of love from your coterie and family can matter a lot.

Talking to a cancer survivor can mean a great deal of motivation for you.

It is believed that stress reduces with communication.

When you communicate and tell your loved ones about your feelings, you should feel light and burden-free.

Prostate Cancer Caregiver Podcast Series

We are proud to announce a new podcast series geared toward helping give support, hope and guidance to prostate cancer caregivers. The goal of this Prostate Cancer Caregiver Podcast Series is to help others connect with a diverse group of people who have felt the impact of prostate cancer in their lives and empower them on their journey.

How Is Prostate Cancer Diagnosed

A biopsy is when a small piece of tissue is removed from the prostate and looked at under a microscope.

A biopsy is a procedure that can be used to diagnose prostate cancer. A biopsy is when a small piece of tissue is removed from the prostate and looked at under a microscope to see if there are cancer cells.

A Gleason score is determined when the biopsy tissue is looked at under the microscope. If there is a cancer, the score indicates how likely it is to spread. The score ranges from 2 to 10. The lower the score, the less likely it is that the cancer will spread.

A biopsy is the main tool for diagnosing prostate cancer, but a doctor can use other tools to help make sure the biopsy is made in the right place. For example, doctors may use transrectal ultrasound or magnetic resonance imaging to help guide the biopsy. With transrectal ultrasound, a probe the size of a finger is inserted into the rectum and high-energy sound waves are bounced off the prostate to create a picture of the prostate called a sonogram. MRI uses magnets and radio waves to produce images on a computer. MRI does not use any radiation.

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Should I Be Screened For Prostate Cancer

Since there are benefits and risks to prostate screening, you should talk with your provider to decide if screening is right for you. You and your provider should consider:

  • Your age. The risk of prostate cancer increases after age 50.
  • Your family health history. If members of your family have had prostate cancer, your risk may be higher.
  • Your race. Prostate cancer is more common in African Americans. They also have a higher risk of developing prostate cancer at a younger age and having more serious disease.
  • Your general health. Are you well enough to have treatment for prostate cancer if it’s found?
  • What you prefer. How do you feel about the possible benefits and harms of screening, diagnosis, and treatment?

NIH: National Cancer Institute

What If I Am Diagnosed With Prostate Cancer

Prostate Cancer

Many people have been where you are standing. Dont lose hope. More than 3.1 million American men have been diagnosed with prostate cancer and are alive today.

The first thing you should consider doing is to find out about the specifics of your cancer. You should know your stage and grade .

From there you can find out what treatment options you want to pursue, if any. Talk to your doctors. Choose a healthcare team of different specialists, or consult a second opinion. You can also do your own research, or talk to men who have been in your position. Many of our advocates are patients and survivors hear their stories at the video library. Or head to the rest of our website to start some research.

Learn

Also Check: Stage 4 Prostate Cancer Survival Rate Without Treatment

Prostate Cancer: Advancements In Screenings

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.

Use In Men Who Might Have Prostate Cancer

The PSA blood test is used mainly to screen for prostate cancer in men without symptoms. Its also one of the first tests done in men who have symptoms that might be caused by prostate cancer.

PSA in the blood is measured in units called nanograms per milliliter . The chance of having prostate cancer goes up as the PSA level goes up, but there is no set cutoff point that can tell for sure if a man does or doesnt have prostate cancer. Many doctors use a PSA cutoff point of 4 ng/mL or higher when deciding if a man might need further testing, while others might recommend it starting at a lower level, such as 2.5 or 3.

  • Most men without prostate cancer have PSA levels under 4 ng/mL of blood. Still, a level below 4 is not a guarantee that a man doesnt have cancer.
  • Men with a PSA level between 4 and 10 have about a 1 in 4 chance of having prostate cancer.
  • If the PSA is more than 10, the chance of having prostate cancer is over 50%.

If your PSA level is high, you might need further tests to look for prostate cancer.

To learn more about how the PSA test is used to look for cancer, including factors that can affect PSA levels, special types of PSA tests, and what the next steps might be if you have an abnormal PSA level, see Screening Tests for Prostate Cancer.

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Psa Blood Test For Prostate Cancer

PSA levels are measured as ng/mL. According to the ACS:

  • Men with a PSA level between 4 and 10 have about a 25 percent chance of having prostate cancer.
  • Men with a PSA level higher than 10 have more than a 50 percent chance of having prostate cancer.

Not all men with high PSA levels have prostate cancer. High levels may also be caused by a urinary tract infection, prostatitis or benign prostatic hyperplasia, all of which are noncancerous conditions. Conversely, men with a low PSA level may still develop prostate cancer.

PSA tests are not an indication of how aggressive the prostate cancer may be. Many prostate cancers are slow-growing and dont require immediate treatment.

What Is The Prognosis For People Who Have Prostate Cancer

Prostate cancer: warning signs, diagnosis and treatment

Because prostate cancer tends to grow slowly, most men die from something other than the disease. Early detection is key to better outcomes. Almost all men 97% to 98% diagnosed with localized cancer that hasnt spread outside of the prostate live at least five years after diagnosis. When metastatic cancer has spread outside of the gland, one-third of men continue to survive after five years.

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What Causes Prostate Cancer

Experts arent sure why some cells in the prostate gland become cancerous . Genetics appear to play a role. For example:

  • Youre two to three times more likely to get prostate cancer if your father, brother or son has the disease.
  • Inherited mutated breast cancer genes and other gene mutations contribute to a small number of prostate cancers.

A Note On Suspicious Results

A suspicious result indicates that the biopsy sample contained some abnormalities but no cancer was found. There are a couple of potential explanations for a suspicious prostate biopsy result, including:

  • Prostatic intraepithelial neoplasia refers to changes within prostate cells that are abnormal, but not indicative of cancer. This condition is low-grade or high-grade, depending on how abnormal the cells are. Low-grade PIN is very common and isn’t associated with prostate cancer. High-grade PIN, however, is associated with a higher risk of prostate cancer. If you have high-grade PIN after a prostate biopsy, your doctor may recommend that biomarker tests be performed on the sample to learn more about the cells. Alternatively, another prostate biopsy may be suggested.
  • Atypical small acinar proliferation indicates that the biopsy sample contains some cells that appear to be cancerous, but not enough to confirm the diagnosis. In most cases, this finding suggests that another prostate biopsy is needed.
  • Proliferative inflammatory atrophy describes a prostate biopsy that reveals inflammation in the prostate and abnormally small prostate cells. While these cells arent cancerous, having PIA may be associated with an increased risk of developing prostate cancer.

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Recent Advances Can Help Men With A Worrisome Psa Result Avoid Immediate Biopsy

Prostate-specific antigen blood testing receives high marks as an effective way to monitor disease activity in men diagnosed with prostate cancer. Yet, as a screening tool for prostate cancer, PSA testing is problematic.

PSA naturally tends to increase as men get older, but levels that get too high may suggest prostate cancer. A PSA level of less than 4 nanograms per milliliter is often reassuring, unless there has been a sudden jump from a much lower number. Many doctors consider a total PSA level higher than 10 ng/mL as the threshold for getting a biopsy to check for cancer.

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Use In Men Already Diagnosed With Prostate Cancer

Prostate Cancer: Symptoms &  Signs : Infographics

The PSA test can also be useful if you have already been diagnosed with prostate cancer.

  • In men just diagnosed with prostate cancer, the PSA level can be used together with physical exam results and tumor grade to help decide if other tests are needed.
  • The PSA level is used to help determine the stage of your cancer. This can affect your treatment options, since some treatments are not likely to be helpful if the cancer has spread to other parts of the body.
  • PSA tests are often an important part of determining how well treatment is working, as well as in watching for a possible recurrence of the cancer after treatment .

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Try To Be As Active As Possible

Newly diagnosed prostate cancer patients should adopt an active lifestyle.

Studies show that exercise reduces stress and anxiety.

Incorporating light exercise is important because evidence shows that physical exercise reduces cancer incidence and also lowers the risk of recurrence.

As per a systematic review and meta-analysis, exercise can reduce cancer-related fatigue.

How Is Prostate Cancer Treated

Lorenzo asked his doctors about survival and side effects and talked to friends and family members before deciding on treatment. He shares his story in this blog post.

Different types of treatment are available for prostate cancer. You and your doctor will decide which treatment is right for you. Some common treatments are

  • Expectant management. If your doctor thinks your prostate cancer is unlikely to grow quickly, he or she may recommend that you dont treat the cancer right away. Instead, you can choose to wait and see if you get symptoms in one of two ways:
  • Active surveillance. Closely monitoring the prostate cancer by performing prostate specific antigen tests and prostate biopsies regularly, and treating the cancer only if it grows or causes symptoms.
  • Watchful waiting. No tests are done. Your doctor treats any symptoms when they develop. This is usually recommended for men who are expected to live for 10 more years or less.
  • Surgery. A prostatectomy is an operation where doctors remove the prostate. Radical prostatectomy removes the prostate as well as the surrounding tissue.
  • Radiation therapy. Using high-energy rays to kill the cancer. There are two types of radiation therapy
  • External radiation therapy. A machine outside the body directs radiation at the cancer cells.
  • Internal radiation therapy . Radioactive seeds or pellets are surgically placed into or near the cancer to destroy the cancer cells.
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    Discuss Prostate Cancer Testing With Your Doctor

    Medical authorities do not recommend that all men should be tested for prostate cancer. In fact, most authorities suggest that men should make their own choice about whether or not to have a PSA test. If you decide to be tested, it is recommended that it should be done every two years from 50 to 69 years of age, and only if your health is such that you expect to live for at least another seven years.

    Men at high risk of prostate cancer, such as men with a family history of prostate cancer , or men who have previously had an elevated test result, can start two-yearly testing from age 45. Your doctor can help you decide whether this is necessary.

    While there is now some evidence that regular testing may prevent prostate cancer deaths, there are concerns that many men may be diagnosed and treated unnecessarily as a result of being screened, with a high cost to their health and quality of life .

    However, the option of active surveillance, where a low-risk cancer is watched closely instead of being treated, helps to lower these risks. Active surveillance is now used quite commonly in Australia for men with low-risk prostate cancer.

    If you are unsure whether or not to be tested after considering the benefits and uncertainties of testing and your own risk of prostate cancer, discuss it with your doctor.

    In Australia, if you choose to be tested for prostate cancer the tests are covered by Medicare.

    Medical History And Physical Exam

    What are the Symptoms of Prostate Cancer?

    If your doctor suspects you might have prostate cancer, you will be asked about 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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    What Are The Stages Of Prostate Cancer

    Your healthcare provider uses the Gleason score and Grade Groups to stage prostate cancer based on its projected aggressiveness. To get this information, the pathologist:

    • Assigns a grade to each type of cell in your sample. Cells are graded on a scale of three to five . Samples that test in the one to two range are considered normal tissue.
    • Adds together the two most common grades to get your Gleason score .
    • Uses the Gleason score to place you into a Grade Group ranging from one to five. A Gleason score of six puts you in Grade Group 1 . A score of nine or higher puts you in Grade Group five . Samples with a higher portion of more aggressive cells receive a higher Grade Group.

    Positron Emission Tomography Scan

    A PET scan is similar to a bone scan, in that a slightly radioactive substance is injected into the blood, which can then be detected with a special camera. But PET scans use different tracers that collect mainly in cancer cells. The most common tracer for standard PET scans is FDG, which is a type of sugar. Unfortunately, this type of PET scan isnt very useful in finding prostate cancer cells in the body.

    However, newer tracers, such as fluciclovine F18, sodium fluoride F18, and choline C11, have been found to be better at detecting prostate cancer cells.

    Other newer tracers, such as Ga 68 PSMA-11, 18F-DCFPyl , and Ga 68 gozetotide , attach to prostate-specific membrane antigen , a protein that is often found in large amounts on prostate cancer cells. Tests using these types of tracers are sometimes referred to as PSMA PET scans.

    These newer types of PET scans are most often used if its not clear if prostate cancer has spread. For example, one of these tests might be done if the results of a bone scan arent clear, or if a man has a rising PSA level after initial treatment but its not clear where the cancer is in the body. PSMA PET scans can also be used to help determine if the cancer can be treated with a radiopharmaceutical that targets PSMA.

    Doctors are still learning about the best ways to use these newer types of PET scans, and some of them might not be available yet in all imaging centers.

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    A Prostate Specific Antigen Test

    The prostate specific antigen test is a blood test that may be offered to you as routine screening in the context of a checkup by a primary care physician or urologist.

    But using the test for routine screening is controversial. Elevated results on a PSA test may occur for reasons other than cancer, such as an enlarged prostate, benign prostatic hyperplasia , or an infection in the prostate called prostatitis. Men who receive an elevated result may be referred for further testing. For this reason, the test should only be done after an informed conversation between doctor and patient takes place.

    The American Cancer Society uses these parameters to evaluate PSA results:

    • A PSA test result below 4 nanograms per milliliter means that 85 percent of the time, you wont have prostate cancer.
    • A PSA between 4 and 10 is associated with a 1 in 4 chance of having prostate cancer.
    • If your PSA is greater than 10, you have a 1 in 2 chance of having prostate cancer.

    But doctors have not adopted a uniform system for interpreting PSA. Thresholds for concern and reference ranges vary considerably.

    If your PSA test results are elevated you will likely be advised to have more tests.

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