Prostate Cancer Health Article

Digital rectal examination (DRE)

In order to perform this test, the doctor puts a gloved, lubricated finger (digit) into the rectum to feel for any lumps in the prostate. The rectum lies just behind the prostate gland, and a majority of prostate tumors begin in the posterior region of the prostate. If the doctor does detect an abnormality, he or she may order more tests in order to confirm these findings.

BLOOD TESTS. Blood tests are used to measure the amounts of certain protein markers, such as prostate-specific antigen (PSA), found circulating in the blood. The

cells lining the prostate generally make this protein and a small amount can be detected in the bloodstream. However, prostate cancers produce a lot of this protein, and it can be easily detected in the blood. Hence, when PSA is found in the blood in higher than normal amounts for the patient's particular age group, cancer may be present.

TRANSRECTAL ULTRASOUND. A small probe is placed in the rectum, and sound waves are released from the probe. These sound waves bounce off the prostate tissue and an image is created. Since normal prostate tissue and prostate tumors reflect the sound waves differently, the test can be used to detect tumors quite efficiently. Though the insertion of the probe into the rectum may be slightly uncomfortable, the procedure is generally painless and takes only 20 minutes.

PROSTATE BIOPSY. If cancer is suspected from the results of any of the above tests, the doctor will remove a small piece of prostate tissue with a hollow needle. This sample is then checked under the microscope for the presence of cancerous cells. Prostate biopsy is the most definitive diagnostic tool for prostate cancer.

If cancer is detected during the microscopic examination of the prostate tissue, the pathologist will "grade" the tumor using a method called the Gleason system. This means that he or she will score the tumor on a scale of 1–10 to indicate how aggressive the tumor is. Tumors with a lower score are less likely to grow and spread than are tumors with higher scores. The Gleason system is different from "staging" of the cancer. When a doctor stages a cancer, he or she gives it a number that indicates whether it has spread, as well as the extent of its spread. In Stage I, the cancer is localized in the prostate in one area, while in the last stage, Stage IV, the cancer cells have spread to other parts of the body.

X RAYS AND IMAGING TECHNIQUES. A chest x ray may be ordered to determine whether the cancer has spread to the lungs. Imaging techniques (such as computed tomography scans and magnetic resonance imaging), where a computer is used to generate a detailed picture of the prostate and areas nearby, may be done to get a clearer view of the internal organs. A bone scan also may be used to check whether the cancer has spread to the bone.