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Prostate Cancer

Diagnosis and Staging of Prostate Cancer

If you or a loved one experience any of the symptoms or signs associated with prostate cancer, you must immediately make an appointment with a physician. There's a range of tests to determine whether you have prostate cancer.

Tests

Digital rectal examination (DRE)

This is the first and most routine test. In fact, many prostate problems are discovered during this exam, which is a standard part of routine checkups for middle-aged males. Your doctor will be able to feel your prostate gland after gently inserting a lubricated and gloved finger in your rectum. A healthy gland is soft and fleshy. Cancerous prostates can be hard, even stony to the feel. However, only up to one-third of diseased prostates are undetectable by feel, so this won’t be your doctor's only means of diagnosis.

PSA test

PSA (Prostate Specific Antigen) is a substance that’s only produced in the prostate. Under normal conditions, very little PSA will leak into the bloodstream, but the patient can have an elevated degree of leakage if the prostate is cancerous. However, this can also occur if the patient has a less serious condition known as BPH, also called benign (non-cancerous) enlargement or an infection in the prostate,

Biopsy Done with Transrectal ultrasound (TRUS)

Sometimes a physician will be able to suspect cancer based on an ultrasound image. But more commonly, a biopsy must be performed. With the aid of an ultrasound device on the end of a transrectal probe, your doctor will remove several small sections of the prostate for microscopic examination. This is done during the course of a 20-30 minute outpatient procedure. During the examination phase, a pathologist will be able to determine whether the prostate is cancerous, and the stage of development.

Staging of Prostate Cancer

Prostate cancer is assigned a "stage," which is a way of judging the extent of the cancer. The spectrum of the seriousness of the disease takes it from such slow growth that no treatment is necessary, to immediately life-threatening. If cancer is diagnosed, your physician will explain what stage your condition is in, and the treatment you should undergo.

Gleason Score

Prostate cancer is also ranked by level of "aggressiveness." For this, the Gleason grading system is most commonly used. A Gleason score of 2 to 4 is the mildest and most treatable form of the disease. A score in the 8 to 10 range is the most serious and least responsive to treatment. Most patients have scores in the 6-7 range.

PSA Score

Another scale to rate aggressiveness is determined by PSA levels in the bloodstream. A PSA score of 10 or less is the most ideal, whereas a value greater than 20 is the more serious.

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Last Reviewed: Mar 10, 2006