Testing / Treatment
Testing for Prostate Cancer
How prostate cancer is diagnosed.
If your doctor thinks you might have Prostate Cancer, a number of tests can be done to find out for certain. These tests will also check the size of the cancer and find out if it has spread. It is important that you understand what it will mean if a test shows you have cancer. You need to think beforehand about whether you would want to have treatment. This will depend on your age, health, what you want and the stage of the cancer. Your doctor can help you decide what is best for you.
Blood test (PSA) to measure levels of prostate specific antigens in the blood.
You may have some or all of the following tests:
Blood test (PSA) to measure levels of prostate specific antigens in the blood. If the levels of PSA are high and a rectal examination is abnormal, there is about a 60% chance of Prostate Cancer being found. However, most men with a normal feeling prostate and a slightly raised PSA level do not have cancer.
Digital rectal examination (DRE) where the doctor places a finger inside the rectum, or back passage, to check for changes to the surface of the prostate:
Biopsy Bone scan
Computerised tomography (CT) scan
Magnetic resonance imaging (MRI)
‘Staging’ the disease
The tests described above show whether you have cancer. They will also show where the cancer is and whether the cancer cells have spread to other parts of your body. This helps your doctors ’stage’ the disease.
‘Stage’ describes the extent of the cancer in your body. It helps show which treatment is needed. It also is a guide to prognosis.
A common ’staging system’ used for Prostate Cancer is the TNM system (T = tumour N = nodes M = metastases)
- T followed by a number between 1 and 4 shows whether and how far the cancer has spread in the area of the prostate. A higher number after the T (for example, T3 or T4) means it has spread beyond the prostate into tissue around the prostate, or to nearby organs (the bladder or rectum). Men with T1 or T2 disease have cancer that is probably confined within the prostate (early prostate cancer).
- N1 means the cancer has spread to a lymph node or nodes near the prostate. N0 means the cancer has not spread to any lymph nodes.
- M followed by 1a, b or c shows that the cancer has spread to bone or other sites.Ask your doctor to explain the stage of your cancer in a way you can understand. This will help you choose the best treatment for your situation.
Treatment for Prostate Cancer
The type of treatment will depend on a number of factors. These include:
- The stage of the cancer- localized in the prostate gland or spread to other parts of the body
- The Gleason score- high (more aggressive) or low grade biopsy grading
- The level of PSA in the blood stream
- The man’s age
- The man’s general medical health
- The side-effects of treatment
However, the final decision about the most appropriate treatment needs to be made on an individual basis, taking into account the wishes and decision of each patient.
Options for men whose cancer has not spread.
There are several options for men whose cancer has not spread beyond the prostate.
- Watchful waiting
- Surgery – (Radical (total) prostatectomy)
- Transurethral resection of the prostate (TURP)
- External radiotherapy
- Brachytherapy (internal radiotherapy)
Options for men whose prostate cancer has spread
- Hormone treatment with surgery
- Hormone injections
- Palliative treatment
If the Prostate Cancer is aggressive and has spread to other parts of the body, hormone therapy in combination with surgery or radiotherapy is often recommended.
Prostate Cancer can be treated best when the cancer is found early and is still confined to the prostate.
In many cases, the cancer does not go away after treatment but stops growing or shrinks in size. Men usually return to normal or near normal good health. This may last for months or years.
After your treatment is finished, your doctor will recommend regular check-ups. If you have any new symptoms, you should see your doctor.