Causes Of Prostate Cancer
The causes of prostate cancer are largely unknown. But certain things can increase your risk of developing the condition.
The chances of developing prostate cancer increase as you get older. Most cases develop in men aged 50 or older.
For reasons not yet understood, prostate cancer is more common in black men and less common in Asian men.
Men whose father or brother were affected by prostate cancer are at slightly increased risk themselves.
Recent research also suggests that obesity increases the risk of prostate cancer.
Identifying Potential Prostate Problems
New Prostate Cancer Blood Test
If you have an abnormal PSA score, your doctor may recommend another newertest that gives a better sense of yourprostate cancer risk. The prostate health index is one such test that is a more accurateblood test and measures your risk for having prostate cancer. Its approvedby the FDA for men who have PSA scores between 4 and 10.
What are the benefits of the PHI test?
- Fewer unnecessary biopsies: Some men who have elevated PSA scores are unsure about getting an invasive biopsy. This tool can be used to better determine whether your risk is high enough to warrant a biopsy.
- More accurate: This test is better at detecting prostate cancer. It can also detect whether you have a more aggressive type of cancer. This information can guide doctors to a more targeted treatment plan for you.
If you score low on the PHI test, your doctor may recommend monitoring youover time to see if your levels rise enough to cause concern.
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What Is The Easiest Way To Find The Prostate
Finding the prostate gland shouldnt be difficult if you know where it is. The gland is adjacent to the rectum with no space in between.
That is why the digital rectal examination is one of the screening methods for prostate cancer. Doctors need some practice before locating the prostate gland, but it is not hard.
Heres what you can do :
- Insert your finger and search through.
- Push gently to the front with your fingertips. Do this alone so you can concentrate and take your time.
- Try to feel a different sensation using your fingertips. They are more sensitive than the rest of the finger.
Finding the prostate will be easier if you try a few positions :
- Fetal position: It is an excellent way to start, and the one recommended by doctors is to perform a rectal exam. Lay on your side and curl your body with your legs drawn up.
- Doggy position: It is a suitable option for couples if you want your partner to give you a prostate massage.
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Repeating The Psa Test
A mans blood PSA level can vary over time , so some doctors recommend repeating the test after a month or so if the initial PSA result is abnormal. This is most likely to be a reasonable option if the PSA level is on the lower end of the borderline range . For higher PSA levels, doctors are more likely to recommend getting other tests, or going straight to a prostate biopsy.
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When Should I Call My Healthcare Provider
If youre 50 and you havent had your first prostate exam yet, call your healthcare provider to set up an appointment. If youre at higher risk, such as if you’re Black or prostate cancer runs in your family, you should have your first prostate exam by age 45.
Furthermore, if you develop symptoms of urinary tract obstruction, schedule a visit with your provider right away. This may indicate an enlarged prostate, benign prostatic hyperplasia or a urinary tract infection.
A note from Cleveland Clinic
Most people are understandably apprehensive about their first prostate exam. Learning all you can about the process can help abate any fears or uncertainties you have. Talk to your healthcare provider about your screening options. A prostate exam is the first step in the early detection of prostate cancer and early detection is key to successful treatment.
Last reviewed by a Cleveland Clinic medical professional on 04/04/2022.
How Do Doctors Test For Prostate Cancer
There is no single test for prostate cancer, so your GP is your first point of call – and they will discuss the options with you.
Diagnosis through the NHS is likely to involve:
- Giving a urine sample
- A blood test to measure your prostate-specific antigen levels
- And a digital rectal examination
PSA is a protein produced by the prostate gland – which all men have.
Your levels increase with age and prostate cancer can, but doesn’t always, increase production of PSA.
But this isn’t a specific test for prostate cancer – 65 per cent of blokes with raised PSA levels don’t have cancer, while 15 per cent of those with tumours get a false negative.
Because of these factors, there is currently no screening programme for prostate cancer here in Britain – so it’s up to you to arrange tests, if you think you could be at risk.
For a definitive diagnosis, some blokes are referred to hospital for a transrectal ultrasound-guided biopsy .
The procedure can be painful, but it allows docs to take a tissue sample from your prostate.
But this test can miss one in five cancers – so you may need a follow-up test if your symptoms persist.
Thankfully, thousands of men could avoid painful invasive cancer tests thanks to a new prostate scan.
The MRI technique works in just over a quarter of cases, a study has found.
The MRI scan is also 12 per cent better at picking up deadly tumours and 13 per cent less likely to flag up a harmless cancer as needing treatment.
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The Test Is Often Not Needed
Most men with high PSAs dont have prostate cancer. Their high PSAs might be due to:
- An enlarged prostate gland.
- Recent sexual activity.
- A recent, long bike ride.
Up to 25% of men with high PSAs may have prostate cancer, depending on age and PSA level. But most of these cancers do not cause problems. It is common for older men to have some cancer cells in their prostate glands. These cancers are usually slow to grow. They are not likely to spread beyond the prostate. They usually dont cause symptoms, or death.
Studies show that routine PSA tests of 1,000 men ages 55 to 69 prevent one prostate cancer death. But the PSA also has risks.
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What Happens After The Dre
If any abnormalities are found during the DRE, the doctor may order more tests and possibly schedule a prostate biopsy to see if there are any signs of cancer present.
If there are no signs of prostate cancer found during screening, the results of the PSA blood test may help to determine the time between future prostate cancer screenings. PSA levels vary by age and other factors.
Ultimately, you and your doctor will decide how often you should be screened since your diet, health and lifestyle habits are all factors on the timing and frequency of your prostate cancer screenings. Be sure to consult with your doctor if you notice any changes in your health.
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What Happens If You Have A Likert Score Of 3 Or More
This result on its own doesnt mean that you definitely have prostate cancer. But its more likely that you do. Your doctor is likely to recommend for you to have a biopsy.
The MRI scan also helps doctors know where to take the biopsy from. You usually have tissue samples taken from the suspected area of cancer and also from the rest of the prostate. Doctors call these targeted biopsies and systematic biopsies. This is because not all cancers can be seen on an MRI scan.
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What Is A Prostate Ultrasound Used For
A prostate ultrasound is used to check your prostate gland using ultrasound imagery. The procedure provides your doctor with black-and-white images of your prostate and the surrounding tissues. Your doctor usually wont do this as part of a physical examination, but they may recommend it if:
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Understanding Your Mri Results
A doctor who specialises in imaging scans gives the MRI scan a score based on the results. This score helps your doctor decide on the next step and whether you need to have a biopsy. This is where your doctor takes a sample of your prostate gland.
This score is called the Likert or PI-RAD system. It estimates the risk that an area seen on the MRI scan may be a cancer or not. The score is from 1 to 5.
|Its highly unlikely that you have prostate cancer|
|2||Its unlikely that you have prostate cancer|
|3||Its difficult to tell from the scan if a prostate cancer is present or not|
|4||Its likely that you have prostate cancer|
|5||Its very likely that you have prostate cancer|
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:
- an enlarged prostate 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. A person should tell their doctor about any medications and supplements they take 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.
Some newer tests the results of the PSA test. They can help assess the risk for people with borderline scores to decide if they need further intervention.
The Prostate Health Index combines the results of:
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When Is A Psa Test Needed
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.
The Role Of Psa In Choosing The Best Treatment
If you have received a diagnosis of prostate cancer, your PSA levels can be used along with the results of other tests and physical exams and your tumors Gleason score to help determine which tests are needed for further evaluation and to decide on the best treatment plan. After treatment has begun, your PSA and other tests will be used to determine how well the treatment is working: The more successful the therapy, the lower the PSA.
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Is Going To The Bathroom Frequently A Sign Of Prostate Cancer
Thats one of the challenging things having urinary symptoms is very rarelyalmost nevera sign of prostate cancer. Having urinary symptoms means you should probably be evaluated for an enlarged prostate, also known as benign prostatic hyperplasia . We can treat your urinary symptoms and help you pee better.
If urinary symptoms bring men to the doctor, we can discuss screening for prostate cancer. Thats important because not all men will go to a doctor until theres something wrong with them. And prostate cancer screening really is the only way to detect prostate cancer, because its almost always asymptomatic.
What Are The Prostate Cancer Symptoms I Need To Look Out For
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
Symptoms associated with advanced prostate cancer include:
- 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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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.
Be Vigilant About Your Background
This isnt prevention as such, but involves some research into whether youre genetically more predisposed to the disease.
Having a father or brother whos also been diagnosed with prostate cancer at some point in their life increases your risk twofold. Similarly, black men have a higher risk of prostate cancer, as well as a higher fatality rate if they do get it.
Of course these things are impossible to change, but knowing these factors can prompt you to be more vigilant and see your GP regularly for checkups.
If youre over 50, going to the GP around once a year for them to ask you important questions about any symptoms you might be experiencing are vital.
Theres no magic pill to avoiding prostate cancer, but keeping healthy and active and knowing the signs could save your life.
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How Can I Check For Signs Of Prostate Cancer
In most cases, prostate cancer doesn’t have any symptoms until the growth is big enough to put pressure on the urethra.
- Straining and taking a long time while peeing
- Feeling that your bladder hasn’t emptied fully
Many men’s prostates get larger as they age because of non-cancerous conditions called prostate enlargement and benign prostatic hyperplasia.
These two conditions are more common than prostate cancer – but that doesn’t mean any symptoms should be ignored.
The signs the cancer could have spread include bone, back or testicular pain, loss of appetite and unexplained weight loss.
Men who are black, overweight, over 50 or have a family history of prostate cancer are most at risk.
Getting A Prostate Biopsy
For some men, getting a prostate biopsy might be the best option, especially if the initial PSA level is high. A biopsy is a procedure in which small samples of the prostate are removed and then looked at under a microscope. This test is the only way to know for sure if a man has prostate cancer. If prostate cancer is found on a biopsy, this test can also help tell how likely it is that the cancer will grow and spread quickly.
For more details on the prostate biopsy and how it is done, see Tests to Diagnose and Stage Prostate Cancer.
For more information about the possible results of a prostate biopsy, see the Prostate Pathology section of our website.
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 .