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What Kind Of Doctor Checks For Prostate Cancer

Can A Swollen Prostate If Untreated Cause Prostate Cancer

Doctor is In: Prostate Cancer

We have no evidence of that. Theyre completely unrelated problems. The area of the prostate that causes urinary symptoms is usually a different part of the prostate than where cancer is likeliest to develop.

Doctors divide the prostate into different zones. The zone that is associated with BPHand the majority of prostate growthis the transition zone. Prostate cancer occurs there much less often than in the peripheral zone, which is the outer area.

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?

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 and 18F-DCFPyl , 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.

The pictures from a PET scan arent as detailed as MRI or CT scan images, but they can often show areas of cancer anywhere in the body. Some machines can do a PET scan and either an MRI or a CT scan at the same time, which can give more detail about areas that show up on the PET scan.

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Genetic Testing For Some Men With Prostate Cancer

Some doctors now recommend that some men with prostate cancer be tested to look for certain inherited gene changes. This includes men in whom a family cancer syndrome is suspected, as well as men with prostate cancer that has certain high-risk features or that has spread to other parts of the body. Talk to your doctor about the possible pros, cons, and limitations of such testing.

Examination Of Your Prostate

Prostate Specific Antigen Screening Test

When your doctor examines you it might include feeling your prostate gland. To do this your doctor puts a gloved finger into your back passage to check for abnormal signs, such as a lumpy, hard prostate. Doctors call this test a digital rectal examination .

It’s normal to feel a bit anxious about this test and it might be uncomfortable. But it usually only takes a few minutes.

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Who Should Get A Prostate Exam

Starting at age 50, all men should discuss prostate cancer screening with their doctor. The American Cancer Society advises men at higher risk to have this conversation at age 45.

Youre considered to have an increased risk if youre African-American or if a first-degree relative had prostate cancer before age 65. If more than one first-degree relative had prostate cancer before age 65, you might want to consider beginning prostate cancer screening even earlier.

The ACS estimates there will be about 26,120 men will die from it.

Prostate cancer is easier to treat before it spreads. However, some prostate cancers are so slow-growing that they dont always require treatment. A lot depends on your age and other factors.

Discuss your risk factors with your doctor, and ask if you should have a prostate exam as part of your yearly checkup.

When To Startand Stopscreening

The doctors and researchers who recommend screening argue that cases of prostate cancer found very early can be cured more quickly, with less chance of relapse or spread. Those who recommend against routine screening point to the slow-moving nature of prostate cancer and the side effects of surgical and medical treatment, which can be considerable.

The introduction of PSA screening in the US led to an initial increase in the number of prostate cancer cases diagnosed each year, even though many of these new cases were non-aggressive or low-risk prostate cancer. The issue was not that screening was harmful, it was that many of these low-risk cancers did not necessarily need immediate treatment. It seems strange to say that a patient might be better off leaving cancer untreated, but in some cases, it can be true. For a few years, the United States Preventative Services Task Force recommended against PSA screening. We are now seeing more cases of advanced prostate cancer diagnosed in recent years. This may be a long-tail effect of that USPSTF recommendation. It has now been changed to note that for men aged 55 to 69 years, the decision to undergo PSA screening is an individual one and should be discussed with your doctor. USPSTF continues to recommend against screening for men aged 70 and over.

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Use In Men Already Diagnosed With Prostate Cancer

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 .

How To Check Your Prostate

New Prostate Cancer Scan âIs Going To Be Life-Saving,â Doctor Says

This article was co-authored by Robert Dhir, MD. Dr. Robert Dhir is a board certified Urologist, Urological Surgeon, and the Founder of HTX Urology in Houston, Texas. With over 10 years of experience, Dr. Dhirs expertise includes minimally-invasive treatments for enlarged prostate , kidney stone disease, surgical management of urological cancers, and mens health . His practice has been named a Center of Excellence for the UroLift procedure, and is a pioneer in non-surgical procedures for ED using his patented Wave Therapy. He earned his undergraduate and medical degrees from Georgetown University and was awarded honors in pre-medical studies, urology, orthopedics, and ophthalmology. Dr. Dhir served as chief resident during his urological surgical residency at University of Texas at Houston / MD Anderson Cancer Center in addition to completing his internship in general surgery. Dr. Dhir was voted Top Doctor in Urology for 2018 to 2019, one of the top three Best Rated Urologists in 2019 & 2020 for Houston Texas, and Texas Monthly has named him to the 2019 & 2020 Texas Super Doctors Rising Stars list.wikiHow marks an article as reader-approved once it receives enough positive feedback. This article has 11 testimonials from our readers, earning it our reader-approved status. This article has been viewed 1,038,621 times.

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Treatment Risks And Benefits

There are risks and benefits of each type of therapy.

Radiation therapy. Older studies show that about one-half of patients develop erectile dysfunction within 5 years of having radiation therapy. However, newer forms of radiation may have different outcomes.

  • Many men feel very tired at the end of the treatment period.
  • Erectile dysfunction is a common side effect and often gets worse over time.
  • Some men have side effects like urinary burning, urinary bleeding, frequent urination, rectal bleeding, rectal discomfort, or diarrhea during or shortly after the treatment.
  • More serious complications are rare. However, a degree of uncertainty goes along with radiation treatment. Since the prostate gland and the lymph nodes arent taken out, your doctor cant tell the exact size of the tumor. The cancer could come back many years after radiation treatment.

Radical prostatectomy. The short-term risks of this surgery are low if youre young and in good health.

The main risks of radical prostatectomy are incontinence and impotence.

Hormone therapy. Hormone therapy often is used in combination with other treatments. It does have side effects.

Chemotherapy. Chemotherapy has been shown to help some people who have advanced prostate cancer live longer.

Chemotherapy can have many side effects, including hair loss, nausea, fatigue, and loss of taste.

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.

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Further Testing For Advanced Cancer

If there’s a significant chance the cancer has spread from your prostate to other parts of the body, further tests may be recommended.

These include:

  • an MRI scan, CT scan or PET scan these scans build a detailed picture of the inside of your body
  • an isotope bone scan, which can tell if the cancer has spread to your bones a small amount of radiation dye is injected into the vein and then collects in parts of the bone where there are any abnormalities

How Serious Is My Cancer

Working to Treat a Deadly Form of Prostate Cancer

If you have prostate cancer, the doctor will want to find out how far it has spread. This is called the stage of the cancer. You may have heard other people say that their cancer was stage 1 or stage 2. Your doctor will want to find out the stage of your cancer to help decide what types of treatment might be best for you.

The stage is based on the growth or spread of the cancer through the prostate, and if it has spread to other parts of your body. It also includes your blood PSA level and the grade of the cancer. The prostate cancer cells are given a grade, based on how they look under a microscope. Those that look very different from normal cells are given a higher grade and are likely to grow faster. The grade of your cancer might be given as a Gleason score or a Grade Group . Ask your doctor to explain the grade of your cancer. The grade also can helpdecide which treatments might be best for you.

Your cancer can be stage 1, 2, 3, or 4. The lower the number, the less the cancer has spread. A higher number, like stage 4, means a more serious cancer that has spread outside the prostate.

If your cancer hasn’t spread to other parts of the body, it might also be given a risk group. The risk group is based on the extent of the cancer in the prostate, your PSA level, and the results of the prostate biopsy. The risk group can help tell if other tests should be done, and what the best treatment options might be.

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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.

What Do The Results Mean

PSA levels may be above the baseline for various reasons other than prostate cancer.

Other 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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Questions You Might Want To Ask Your Gp

  • Do I need to see a specialist? Is it urgent?
  • When will I see them?
  • Where will I see them?
  • Will I find out about my appointments by post or telephone?
  • Do I need tests? What will they involve?
  • How long should I expect to wait?
  • Where can I find out more about tests?
  • Do I have to do anything in preparation for this test?
  • When will I get the results and who will tell me?

Your GP might not be able to answer all of your questions. They will tell you what they can at this point. Not knowing is difficult to cope with and can make you anxious.

Speaking to a friend or relative about how you feel might help.

When Is A Psa Test Needed

Prostate Cancer – Screening and Treatment

If you are age 50 to 74, you should discuss the PSA test with your doctor. Ask about the possible risks and benefits.

Men under 50 or over 75 rarely need a PSA test, unless they have a high risk for prostate cancer.

  • You are more likely to get prostate cancer if you have a family history of prostate cancer, especially in a close relative such as a parent or sibling.
  • Your risks are higher if your relative got prostate cancer before age 60 or died from it before age 75. These early cancers are more likely to grow faster.
  • If you have these risks, you may want to ask your doctor about getting the PSA test before age 50.

This report is for you to use when talking with your healthcare provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.

04/2014

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Men At Higher Risk Of Prostate Cancer

Some men are at higher risk of prostate cancer than others. These are:

  • black men
  • men who have a family history of prostate cancer

The risk of prostate cancer also increases as men get older.

The evidence so far doesnt suggest that routinely screening these men would help prevent deaths from prostate cancer. In fact, it might lead to men having treatment for prostate cancer even though that cancer wouldnt have caused any problems or symptoms.

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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Getting The Results Of The Biopsy

Your biopsy samples will be sent to a lab, where they will be looked at with a microscope to see if they contain cancer cells. Getting the results usually takes at least 1 to 3 days, but it can sometimes take longer. The results might be reported as:

  • Positive for cancer: Cancer cells were seen in the biopsy samples.
  • Negative for cancer: No cancer cells were seen in the biopsy samples.
  • Suspicious: Something abnormal was seen, but it might not be cancer.

If the biopsy is negative

If the prostate biopsy results are negative , and the chance that you have prostate cancer isnt very high based on your PSA level and other tests, you might not need any more tests, other than repeat PSA tests sometime later.

But even if many samples are taken, biopsies can still sometimes miss a cancer if none of the biopsy needles pass through it. This is known as a false-negative result. If your doctor still strongly suspects you have prostate cancer , your doctor might suggest:

  • Getting other lab tests to help get a better idea of whether or not you might have prostate cancer. Examples of such tests include the Prostate Health Index , 4Kscore test, PCA3 tests , and ConfirmMDx. These tests are discussed in Whats New in Prostate Cancer Research?
  • Getting a repeat prostate biopsy. This might include getting additional samples of parts of the prostate not biopsied the first time, or using imaging tests such as MRI to look more closely for abnormal areas to target.

Prostate cancer grade

Gleason score

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