The most accurate test for detecting prostate cancer is a prostate biopsy. This biopsy involves taking a tissue sample from the prostate and examining it under a microscope, which can help your doctor determine whether there is an uncontrolled growth of cells in the prostate gland.
During a prostate biopsy, your doctor inserts a thin needle into your prostate under image guidance using magnetic resonance imaging (MRI) and/or a transrectal ultrasound TRUS) to collect a tissue sample. The tissue is then examined in a lab to look for cancer cells. Your doctor may insert the biopsy needle through your rectum (transrectal biopsy) or the skin between the scrotum and anus (transperineal biopsy).
What other screening tests are used to detect prostate cancer?
Because a biopsy is an invasive procedure, your doctor may first use one or more of the following methods to screen for prostate cancer:
When your doctor takes a detailed medical history, they may ask you about your symptoms, underlying health conditions (such as diabetes or high blood pressure) and whether you consume alcohol or tobacco in any form. Your doctor may also ask you whether any of your close family members such as a father, uncle or brother were diagnosed with prostate cancer at a young age (under 65 years). You may also be asked other questions such as whether you have experienced weight loss or a change in sex drive.
Digital rectal examination (DRE)
A thorough physical examination will also allow your doctor to assess your general health by looking for any signs of disease.
Your doctor may order a digital rectal examination (DRE). During a DRE, your doctor will insert a gloved, lubricated finger into your rectum and try to feel for any lumps, irregularities or hard areas on the prostate that could suggest cancer. This examination will also provide clues as to whether the cancer is in one or both sides of the prostate and whether it has spread to the nearby structures.
Prostate-specific antigen (PSA) blood test
Your doctor may order blood tests to look for blood counts or inflammatory markers (substances increased in the blood in response to an infection or inflammation). One blood test may measure the levels of a type of protein called PSA, which is made by both normal and cancerous cells in the prostate.
A PSA test does not indicate with 100% accuracy whether a person has prostate cancer. Thus, it is generally used to screen high-risk groups or as a preliminary test. Most people without prostate cancer have PSA levels less than 4 ng/mL (nanograms per milliliter). There is almost a 50% chance that a person has prostate cancer if their blood PSA levels are above 10 ng/mL. However, men with prostate cancer may have PSA levels less than 4 ng/mL. Moreover, higher PSA levels may be observed in noncancerous conditions such as benign prostatic hyperplasia (BPH).
Is a prostate biopsy painful?
Chances of feeling any significant pain during a prostate biopsy are generally low, because your doctor will numb the area with an anesthetic shot.
However, you may feel some pain after the procedure, especially when sitting. Pain may occur in the area between the anus and scrotum and can last for a day or two. Your doctor may prescribe pain medications and suggest that you take it easy for a few days after the procedure.
What are potential complications of a prostate biopsy?
While prostate biopsy is a fairly quick and simple procedure that takes about 10 minutes to complete, complications of the procedure may include:
- Pain lasting for a few days or a week
- Hematuria (blood in urine) lasting for a few days to many weeks
- Blood in stools lasting for a day or two
- Blood in the semen lasting for four to eight weeks
- Fever with chills (indicative of an infection and must be reported immediately to your doctor)
- Inability to pass urine or urinary retention (a rare but dangerous complication and one must seek urgent medical attention)
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How Is Prostate Cancer Diagnosed?
Prostate cancer is largely a disease of men over 40, so it’s around this age doctors recommend the first prostate screening. The first exam is a blood test to determine if there are abnormal prostate specific antigen (PSA) levels in your blood – PSA is produced by the prostate. If the PSA is high, your doctor will perform a digital rectal exam, during which the doctor feels your prostate from inside your rectum with a gloved finger. Other diagnostic tests include an endoscopic biopsy of tumor tissue for analysis in a lab.
How Is Prostate Cancer Screening Done?There are no standard or routine screening tests for prostate cancer. Studies are being done to find ways to make prostate-specific antigen (PSA) testing more accurate for early cancer detection.
How Painful Is a Prostate Biopsy?A prostate biopsy is a simple surgical procedure that takes just 10 minutes. It involves inserting the biopsy needle through the wall of your rectum to reach your prostate to cut and remove around 10-12 small samples of tissue from the prostate. The idea of the procedure makes a prostate biopsy appear as an extremely painful procedure.
Prostate cancer is the most common cancer in men after skin cancer.
- Risk factors include age, family history, ethnicity, and diet.
- Prostate cancer is diagnosed by a digital rectal exam, prostate-specific antigen (PSA) test, and prostate biopsy.
- Symptoms may include
- frequent need to urinate,
- incontinence, pain,
- blood in the urine,
- fatigue, and more.
- Prognosis and treatment depend on cancer staging.
- Watchful waiting,
- cryotherapy, and
- other management strategies are available.
- Research and clinical trials strive to find new and better treatments for prostate cancer.
Prostate Cancer QuizIs prostate cancer the most common cancer in men? Take this prostate cancer quiz to find out and learn the causes, symptoms, and treatments of this disease.
Prostate Cancer Facts
Prostate cancer is a leading cause of cancer and cancer death in males; in some men, identifying it early may prevent or delay metastasis and death from prostate cancer.
- The prostate is a walnut-shaped gland that is a part of the male reproductive system that wraps around the male urethra at it exits the bladder.
- Prostate cancer is common in men over 50 years of age, with the risk of developing prostate cancer increases with aging.
Signs of Prostate Cancer: Symptoms, PSA Test, TreatmentsWhat is prostate cancer? Prostate cancer is the most common cancer in men. Learn the signs and symptoms of prostate cancer, along with causes and treatments. Know the stages, survival rates and how to lower your risk of prostate cancer.
Prostate Cancer Early Signs and Symptoms
Difficulty with urination – frequency, weak stream, trouble getting started, etc. – is usually the first sign of prostate cancer. But these and other early symptoms of prostatic cancer can also come from benign prostate conditions, so diagnostic testing is important, including PSA tests and digital rectal exam.
Prostate Cancer Staging and Survival Rates
The prognosis for prostate cancer, as with any cancer, depends on how advanced the cancer has become, according to established stage designations. The patient's PSA score at diagnosis, as well as their Gleason score (the grading system used to determine the aggressiveness of prostate cancer) determines the prognosis and final stage designation. Prostate cancer has a high survival rate in general, but your chances depend on the stage of the cancer.
How Long Does It Take to Recover From a Prostate Biopsy?A patient may take about four to six weeks or even more to recover after a prostate biopsy. The recovery process after biopsy usually depends on the patient's health and age. Doctors may recommend only light activities for 24-48 hours after a prostate biopsy.
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