May 11th, 2016
Are you aware that each year more than 129.4 per 100,000 new cases of prostate cancer are reported in the United States alone? Despite excellent prognosis and quality treatment, prostate malignancy claims 20.7 cancer sufferers per 100,000 each year (1). Experts suggests that early diagnosis can reduce the risk of morbidity and mortality in patients.
The identification of prostate malignancy involves two types of tests:
Serum levels of Prostate Specific Antigen (PSA) are used to screen patients for prostate cancer. It is ideally recommended to get screened after 40 -50 years of age (or even earlier if you have certain risk factors that makes you more likely to get the cancer). But there is no general consensus. For example:
High serum PSA levels are usually suggestive of prostate cancer, but normal PSA levels doesn’t necessarily mean that there is no cancer. This happens in some cases, when prostate cancer grows very quickly. Such condition is referred to as ‘false negative’ i.e. you have prostate cancer but test results are showing that you do not have cancer.
Since PSA screening is very complex therefore, you must consult a doctor who has expertise in interpreting PSA levels.
2. Digital Rectal Examination
Besides PSA screening there are other diagnostic tools as well for the detection of prostate cancer. Digital rectal examination involves insertion of a gloved lubricated finger in the rectum to feel the posterior border and edges of prostate gland. During DRE, your doctor also looks for:
Digital rectal examination has two benefits over PSA. Along with prostate cancer it can also help in diagnosing rectal cancers. Moreover, it is a safe, easy and less expensive test. Yet, some people find it embarrassing and uncomfortable.
These tests are usually performed as the second set of investigations to confirm the presence of cancer as well as other information regarding the tumor (such as size, morphology, location etc.)
Investigators utilize ultrasonic radiations to obtain the exact shape, size and morphology of prostate gland to see:
Ultrasound of prostate gland is performed by a small cigar shaped probe that is inserted via rectum to obtain clear images.
2. Prostate Biopsy:
Biopsy of prostate gland under ultrasound guidance is the gold-standard diagnostic procedure. It involves extraction of a small piece of gland via needle or core biopsy and visualization under the microscope to identify abnormal/ cancer cells. There are several benefits of this procedure such as:
Besides these basic tests, your healthcare provider may also advise a number of tests to ascertain the extent of spread of cancer cells (distant metastasis) and local invasion of tumor cells. Some classic tests include:
If you or someone in your family is at risk of developing prostate cancer, speak to your primary care provider to schedule screening tests for early identification of prostate cancer.
2. Puech, P., Rouvière, O., Renard-Penna, R., Villers, A., Devos, P., Colombel, M., … & Ouzzane, A. (2013). Prostate cancer diagnosis: multiparametric MR-targeted biopsy with cognitive and transrectal US–MR fusion guidance versus systematic biopsy—prospective multicenter study. Radiology, 268(2), 461-469.
3. Carter, H. B., Albertsen, P. C., Barry, M. J., Etzioni, R., Freedland, S. J., Greene, K. L., … & Penson, D. F. (2013). Early detection of prostate cancer: AUA guideline. The Journal of urology, 190(2), 419-426.