Prostate cancer is a common disease that is potentially life-threatening. However, cure rates are high when it is diagnosed and treated early. Health experts, therefore, advise men older than 50 or younger, if they have a family history of the disease, to take a prostate cancer test as part of their yearly medical check-up. They must also talk to their doctors about the benefits and risks of prostate cancer testing and treatment.
Why and When Should Men Have Prostate Cancer Test?
A prostate cancer test may be done for the following reasons:
- In men older than 50 years old, as part of their annual medical check-up
- Having a close relative with a history of prostate cancer
- Presence of urinary symptoms
Some men do not experience any symptoms during the early stages of prostate cancer. In advanced stages, one may experience the following:
- Trouble urinating
- Reduced force in urination
- Urine has blood
- Semen has blood
- Lower back pain, hip or thigh pain
- Pelvic area discomfort
- Bone pain
- Sexual dysfunction
Prostate Cancer Test
Prostate cancer can be cured when diagnosed and treated early. Currently, the best tests to detect prostate cancer include Digital Rectal Examination (DRE), blood test for Prostate Specific Antigen (PSA) and prostate biopsy.
1. PSA or Prostate Specific Antigen
The blood test for PSA detects a protein that prostate cells produce. Elevated levels of PSA are not necessarily an indication of prostate cancer. However, if prostate cancer exists, PSA levels can predict the extent or stage of the disease. An experienced doctor must evaluate the results of the test and recommend if further testing needs to be done. If your PSA level is just slightly elevated, repeat tests may be done to detect rates of change, which may suggest the need for a prostate biopsy.
2. Digital Rectal Examination
During a DRE, the doctor inserts a gloved finger into the anus to feel the surface of your prostate. If he detects any irregularities such as a hardening, a lump or swelling of the prostate, it may suggest the growth of a tumor or other prostate problems. However, the doctor can only feel a part of the prostate and may miss some irregularities beyond his reach. Studies show that very few men find the procedure embarrassing or painful.
3. Biopsy
This procedure involves taking a tiny tissue sample from the prostate using a needle. An urologist inserts a small probe with an ultrasound generator into the anus, which generates images of the prostate gland on a computer screen and guides him during needle insertion and tissue sampling. The procedure may be done with an anesthetic for pain and preoperative or postoperative antibiotics. The sample is taken to a laboratory for microscopic examination.
4. Urodynamic Tests
Urodynamic testing determines the adequacy of function of the urinary bladder, the sphincters, and the urethra in holding and releasing urine. These tests measure your ability to hold urine in the bladder and whether you can empty it steadily and completely. An enlarged prostate may cause urine blockage and the doctor may recommend testing for urine flow rate and bladder pressure. Urodynamic tests may be performed in a doctor's office without anesthesia, in an outpatient center or in a hospital using local anesthesia.
5. Cystoscopy
This procedure allows the physician to view the lower urinary tract with a tube-like instrument called a cystoscope, which is inserted into the penis. This test is performed by an urologist, a specialist on the urogenital tract, to determine what is causing urine blockage. It may be performed in a doctor's office, an outpatient center or a hospital under local anesthesia.
6. MRI and CT Scan
Magnetic resonance imaging (MRI) involves taking pictures of the tissues and internal organs without the use of x-rays. MRI machines use magnets and radio waves to produce detailed images. A CT scan combines x-ray and computer technology to create 3D images. Just like the MRI, it may also involve injecting of a dye to provide contrast to the images. Both methods can help identify tumors and other abnormalities in the urinary tract, but may not be able to distinguish between cancerous and noncancerous prostate enlargements. These tests are usually performed in an outpatient facility or a hospital with specially trained technicians and radiologists.
7. Ultrasound
A transrectal ultrasound may be used to further evaluate the prostate. A small cigar-shaped probe is inserted into the rectum and sends sound waves to create images of the prostate gland.
8. Isotope Bone Scan
This test involves the injection of a small amount of dye into a vein to help detect if cancer cells have spread to the bones. The radioactive dye collects in bones where cancer cells are present.
Treatments for Prostate Cancer
If prostate cancer tests show positive results, your doctor will recommend treatment options, which may include surgery, radiation, hormone therapy, and chemotherapy (rarely done). Early stages of prostate cancer may be cured with radiation alone or surgery. In some cases, your doctor may recommend no treatment (just observation). The decision on your choice of treatment may be a complex matter and seeking a second opinion is reasonable.