Tests To Diagnose And Stage Prostate Cancer
Most prostate cancers are first found as a result of screening. Early prostate cancers usually dont cause symptoms, but more advanced cancers are sometimes first found because of symptoms they cause.
If prostate cancer is suspected based on results of screening tests or symptoms, tests will be needed to be sure. If youre seeing your primary care doctor, you might be referred to a urologist, a doctor who treats cancers of the genital and urinary tract, including the prostate.
The actual diagnosis of prostate cancer can only be made with a prostate biopsy .
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What If My Test Results Are Abnormal
If the results of early detection tests like the PSA screening 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.
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. Read more on those tests.
Why Does Prostate Cancer Happen
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 men of African-Caribbean or African descent, 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.
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What Is Screening For Prostate Cancer
Some men get a PSA test to screen for prostate cancer. Talk to your doctor, learn what is involved, and decide if a PSA test is right for you.
Cancer screeningexternal icon means looking for cancer before it causes symptoms. The goal of screening for prostate cancer is to find cancers that may be at high risk for spreading if not treated, and to find them early before they spread.
If you are thinking about being screened, learn about the possible benefits and harms of screening, diagnosis, and treatment, and talk to your doctor about your personal risk factors.
There is no standard test to screen for prostate cancer. Two tests that are commonly used to screen for prostate cancer are described below.
Health & Wellnessprostate Cancer Warning Signs: What Doctors Say You Need To Know
Dr. Behfar Ehdaie, a urologic surgeon specializing in prostate cancer at Memorial Sloan Kettering Cancer Center in New York, said that these varying guidelines are due to the different risk factors that each person faces. Things like family history, environmental factors, race and more can all come into play when it comes to assessing prostate cancer risk.
There are specific patient level factors that have to go into that decision, including family history, comorbidities, and life expectancy, said Ehdaie, who said that people who are not expected to live more than another decade may not be advised to get screened. And of course, the patients own preferences are taken into account, their goals, what they want to achieve.
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Is The Psa Test Recommended For Prostate Cancer Screening
Until about 2008, some doctors and professional organizations encouraged yearly PSA screening for men beginning at age 50. Some organizations recommended that men who are at higher risk of prostate cancer, including African-American men and men whose father or brother had prostate cancer, begin screening at age 40 or 45. However, as more was learned about both the benefits and harms of prostate cancer screening, a number of organizations began to caution against routine population screening. Most organizations recommend that men who are considering PSA screening first discuss the risks and benefits with their doctors.
Currently, Medicare provides coverage for an annual PSA test for all Medicare-eligible men age 50 and older. Many private insurers cover PSA screening as well.
How Is The Psa Test Used In Men Who Have Been Treated For Prostate Cancer
The PSA test is often used to monitor patients who have a history of prostate cancer to see if their cancer has recurred . If a mans PSA level begins to rise after prostate cancer treatment, it may be the first sign of a recurrence. Such a biochemical relapse typically appears months or years before other clinical signs and symptoms of prostate cancer recurrence.
However, a single elevated PSA measurement in a patient who has a history of prostate cancer does not always mean that the cancer has come back. A man who has been treated for prostate cancer should discuss an elevated PSA level with his doctor. The doctor may recommend repeating the PSA test or performing other tests to check for evidence of a recurrence. The doctor may look for a trend of rising PSA level over time rather than a single elevated PSA level.
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Adverse Reactionsadvanced Gbrcam Ovarian Cancer
Most common adverse reactions in 20% of patients in clinical trials of LYNPARZA for advanced gBRCAm ovarian cancer after 3 or more lines of chemotherapy were: fatigue/asthenia , nausea , vomiting , anemia , diarrhea , nasopharyngitis/upper respiratory tract infection , dyspepsia , myalgia , decreased appetite , and arthralgia/musculoskeletal pain .
Most common laboratory abnormalities in 25% of patients in clinical trials of LYNPARZA for advanced gBRCAm ovarian cancer were: decrease in hemoglobin , mean corpuscular volume elevation , decrease in lymphocytes , increase in serum creatinine , decrease in platelets , and decrease in absolute neutrophil count .
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.
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Deciding If You Need A Prostate Screening
How Are Researchers Trying To Improve The Psa Test
Scientists are investigating ways to improve the PSA test to give doctors the ability to better distinguish cancerous from benign conditions and slow-growing cancers from fast-growing, potentially lethal cancers. None has been proven to decrease the risk of death from prostate cancer. Some of the methods being studied include:
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When Is It Time To Stop Being Checked For Prostate Cancer
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Image: Thinkstock Its essential to be fully informed about the;potential risks of PSA testing, which includecomplications from biopsies and teratments. |
The answer depends on your current health and your level of concern about cancer.
Routine PSA testing to check for prostate cancer is no longer recommended for most men. But despite what the experts suggest, many men continue to opt for annual PSA tests. This includes a surprisingly large number of men in their 70s. In a recent study in the journal Cancer, more than half of a group of men 75 and older had PSA tests and biopsies.
These men have placed their hope in the value of early diagnosis and treatment, yet stand to gain less from PSA testing than younger men. Across all ages, routine PSA screening leads to life-saving treatment for cancer in about one in every 1,000 men screened.
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Force guidelines: These independent experts on preventive medicine do not recommend PSA screening for prostate cancer in men at any age, due to a lack of definitive evidence that the benefits of PSA testing are greater than the risks. |
What If I Am Diagnosed With 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.
Determining who needs treatment for prostate cancer has evolved with new options to diagnose aggressive vs. indolent disease.;Check out our infographic with more information on what genomic and advanced tests are available based on a mans individual cancer.
Learn
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Prostate Specific Antigen Test
A blood test called 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 that affect the prostate.
As a rule, the higher the PSA level in the blood, the more likely a prostate problem is present. But many factors, such as age and race, can affect PSA levels. Some prostate glands make more PSA than others.
PSA levels also can be affected by
- Certain medical procedures.
How Is Prostate Cancer Treated
For many men with prostate cancer, treatment is not immediately necessary.
If the cancer is at an early stage and not causing symptoms, your doctor may suggest either “watchful waiting” or “active surveillance”.
The best option depends on your age and overall health. Both options involve carefully monitoring your condition.
Some cases of prostate cancer can be cured if treated in the early stages.
Treatments include:
- radiotherapy either on its own or alongside hormone therapy
Some cases are only diagnosed at a later stage, when the cancer has spread.
If the cancer spreads to other parts of the body and cannot be cured, treatment is focused on prolonging life and relieving symptoms.
All treatment options carry the risk of significant side effects, including erectile dysfunction and urinary symptoms, such as needing to use the toilet more urgently or more often.
For this reason, some men choose to delay treatment until there’s a risk the cancer might spread.
Newer treatments, such as high-intensity focused ultrasound and cryotherapy, aim to reduce these side effects.
Some hospitals may offer them as an alternative to surgery, radiotherapy or hormone therapy.
But the long-term effectiveness of these treatments is not known yet.
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Who Should Get A Digital Rectal Exam
Not all medical institutions agree on when men should begin screening for prostate cancer or even if a DRE should be part of the screening.
To help detect prostate cancer in its early stages, the American Cancer Society recommends that men talk to their doctors about the benefits, risks, and limitations of prostate cancer screening before deciding whether to be tested.
For most men at average risk, discussions about screening begin at age 50. However, some doctors recommend that men at higher risk of prostate cancer African-American men or men with a family history of prostate cancer start screening earlier.
What Do You Want Men To Know About Prostate Cancer
The important thing to know is that, if you live long enough, you will probably get prostate cancer. If you live into your 80s, about 80 percent of men have some sort of prostate cancer. That doesnt mean theyre going to die from prostate cancer because, as a percentage, very few men die from prostate cancer. It means its important to be aware of it and consider screening early, so if its a high-grade type, we can identify it and treat it.;
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Should You Know Your Psa Level
Instead of a national screening programme, there is an informed choice programme, called prostate cancer risk management, for healthy men aged 50 or over who ask their GP about PSA testing. It aims to give men good information on the pros and cons of a PSA test.
If you’re a man aged 50 or over and decide to have your PSA levels tested after talking to your GP, they can arrange for it to be carried out free on the NHS.
If results show you have a raised level of PSA, your GP may suggest further tests.
The Problem With Surveillance
When a man is put into the active surveillance category, it can require invasive follow up.
Active surveillance can involve taking a PSA blood test every three months and then having an MRI or biopsy every two years.
The status is also a constant reminder that the person has cancer but his future is uncertain.
About 50 percent of men who partake in active surveillance wind up treating the cancer, even if it doesnt require treatment, researchers noted.
We currently lack the ability to tell which men diagnosed with prostate cancer will need radical treatment and which men will not, Shea Connell, PhD, a researcher and associate tutor at Norwich Medical School and the studys lead author, said in a statement.
Its clear that there is a considerable need for additional, more accurate tests, Connell said.
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Genomic Tools For A Personalized Prostate Cancer Treatment Plan
In an effort to establish the risk level for a mans prostate cancer, doctors have traditionally used prostate cancer characteristics such as PSA level, Gleason score, and tumor stage to estimate the aggressiveness of the disease and help guide treatment decisions. While these characteristics are helpful, they cannot fully determine the risk level of the cancer. The additional information provided by genomic testing can provide greater confidence in the development of a personalized treatment plan.
Should I Get Screened For Prostate Cancer
This video helps men understand their prostate cancer screening options.
In 2018, the U.S. Preventive Services Task Force made the following recommendations about prostate cancer screeningexternal icon
- Men who are 55 to 69 years old should make individual decisions about being screened for prostate cancer with a prostate specific antigen test.
- Before making a decision, men should talk to their doctor about the benefits and harms of screening for prostate cancer, including the benefits and harms of other tests and treatment.
- Men who are 70 years old and older should not be screened for prostate cancer routinely.
This recommendation applies to men who
- Are at average risk for prostate cancer.
- Are at increased risk for prostate cancer.
Other organizations, like the American Urological Association,external icon;the American Cancer Society,external icon;and the American College of Physiciansexternal icon;may have other recommendations.
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Genetics & Genomic Testing
Personalizing Your Prostate Cancer Treatment Through Genomics | Genetics vs. Genomics| Genomic Tools for a Personalized Prostate Cancer Treatment Plan | Biopsy and Imaging | Prostate Cancer Confusion | Presentations by Dr. Heather H. Cheng and Katie Stoll | Test Categories | Other Links| Articles on Genomics | Publications | Videos
While not appropriate for every prostate cancer patient, genomic testing can provide a man and his care team with valuable information at various stages of disease management specific to whether the cancer is likely to be aggressive or indolent, thereby helping him to make an informed decision on how to best address his prostate cancer.
Us TOO is a nonprofit organization that provides educational resources and support services to the prostate cancer community at no charge. We acknowledge and thank the following corporate sponsor for their support, which helped to make the delivery of this content possible.