Early Prostate Cancer (cont.)
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How reliable are the screening tests for prostate cancer?
Neither of the screening tests for prostate cancer is perfect. Most men with mildly elevated PSA levels do not have prostate cancer, and many men with prostate cancer have normal levels of PSA. Also, the DRE can miss many prostate cancers. The DRE and PSA test together are better than either test alone in detecting prostate cancer.
A recent study examining the PSA histories of men enrolled in the Baltimore Longitudinal Study of Aging (BLSA) suggests that PSA velocity may be a better indicator of potentially life-threatening cancer than PSA level. PSA velocity is the rate at which serum PSA levels change over time. The study found that men who had a PSA velocity above 0.35 ng/ml per year had a higher relative risk of dying from prostate cancer than men who had a PSA velocity less than 0.35 ng/ml per year. More studies are needed to determine if PSA velocity more accurately detects potentially life-threatening prostate cancer early.
The NCI Early Detection Research Network (EDRN) has a Prostate Collaborative Group, which is applying a variety of strategies to find better ways to detect prostate cancer early. In addition, the NCI's prostate cancer Specialized Program of Research Excellence (SPORE) program is funding projects to identify new biomarkers to detect prostate cancer.
How is prostate cancer diagnosed?
The diagnosis of prostate cancer can be confirmed only by a biopsy. During a biopsy, a urologist (a doctor who specializes in diseases of urinary and sex organs in men, and urinary organs in women) removes tissue samples, usually with a needle. This is generally done in the doctor's office with local anesthesia. Then a pathologist (a doctor who identifies diseases by studying tissues under a microscope) checks for cancer cells.
Men may have blood tests to see if the cancer has spread. Some men also may need the following imaging tests:
Prostate cancer is described by both grade and stage.
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