Diagnosing Prostate Cancer

   April 3, 2009   

Diagnosing prostate cancer What is a prostate?

The prostate is a small gland as big as a walnut that’s part of a man’s reproductive system. It is located in front of the rectum and under the bladder. It encircles the urethra. It helps make semen – the milky fluid that carries sperm from the testicles through the penis when a man ejaculates.

Overview of Prostate Cancer

  • Average age of diagnosis is 65
  • Usually slow-growing, often asymptomatic in early stages
  • African-American men are 50% more likely to develop prostate cancer than Caucasian men
  • Incidence increases if first-degree relative has prostate cancer
  • Causes include genetic disposition, history of sexually transmitted diseases, high- fat diet, hormones

Stages of Prostate Cancer

Stage 1:
Location: Prostate only
Symptoms: Asymptomatic
Diagnosis: Accidental discovery

Stage 2:
Location: Prostate only
Symptoms: Mild urinary symptoms from enlarged prostate or asymptomatic
Diagnosis: Prostate specific antigen (PSA) elevated or gland palpated during rectal exam

Stage 3:
Location: Outside capsule of prostate; may also be in seminal vesicles
Symptoms: Urinary symptoms, rectal or pelvic pain
Diagnosis: PSA elevated or gland palpated during rectal exam

Stage 4:
Location: Lymph node involvement and metastasis
Symptoms: Urinary symptoms, rectal or pelvic pain, plus pain in affected tissue
Diagnosis: PSA elevated or gland palpated during rectal exam

Recurrent:
Located: Anywhere in body after previous treatment
Symptoms: Determined by tissue involved
Diagnosis: PSA elevated after treatment

Other Diagnostic Testing

  • Prostate Specific Antigen (PSA)
  • Digital rectal exams
  • Transrectal ultrasonography
  • Tissue biopsy
  • Magnetic Resonance Imagery (MRI)
  • Computerized Tomography (CT scan)

Medical Management for Prostate Cancer

Radiation Therapy
Two major forms of radiation therapy used to treat cancer of the prostate are teletherapy and brachytherapy. Side effects of both forms are normally transitory. Side effects include inflammation of the rectum, bowel, and bladder due to the proximity to the prostate and the radiation doses. However, there is a greater preservation of sexual potency with this procedure than surgery.

Hormonal Therapy
This therapy suppresses a tumor’s growth by inhibiting or decreasing the level of circulating testosterone. As a result, the prostate tumor atrophies (decreases in size). Hormone therapy can be given for several years. Side effects usually occur during treatment, but they go away after treatment is finished. Side effects may include loss of sex drive, impotence, and hot flashes.

Cryosurgery
Cryosurgery of the prostate is used to remove prostate cancer in patients who cannot tolerate surgery, and in those with recurrent prostate cancer. In this procedure, the cancerous tissue is killed through freezing and thawing. However, cryosurgery can also cause injury to surrounding organs like the rectum, scrotum, and penis. It can cause numbness and blocked urine.

Robotic laparoscopic surgery
Laparoscopic surgery is done with small incisions using a slender tube with a camera on the end (laparoscope), which may be robotically controlled. The scope is inserted through the navel, and the surgeon can see a highly enlarged image of the prostate. Compared with other types of prostatectomy, this technique may lead to shorter hospital stays, faster recovery, and less blood loss and pain.

Diagnosing Prostate Cancer
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