Often, early-stage prostate cancer has no symptoms or signs. It is usually found through a PSA test or DRE, a process called screening. This type of screening is done during any yearly wellness exam or routine physical in our office. If a PSA test or DRE indicates that prostate cancer may be present, more monitoring and testing is needed to diagnose prostate cancer. When prostate cancer does cause symptoms or signs, it is usually diagnosed in a later stage. These symptoms and signs may include;
-Weak or interrupted urine flow or the need to strain to empty the bladder
-The urge to urinate frequently at night
-Blood in the urine
-Blood in the seminal fluid
-New onset of erectile dysfunction
-Pain or burning during urination, which is much less common
-Discomfort or pain when sitting, caused by an enlarged prostate
Sometimes men with prostate cancer do not have any of these changes. Other noncancerous conditions of the prostate, such as BPH or an enlarged prostate, can cause similar symptoms. Or, the cause of a symptom may be a different medical condition that is not cancer. Urinary symptoms also can be caused by an infection of the bladder or other conditions.
If cancer has spread outside of the prostate gland, a man may experience:
-Pain in the back, hips, thighs, shoulders, or other bones
-Swelling or fluid buildup in the legs or feet
-Unexplained weight loss
-Change in bowel habits
If you are concerned about any changes you experience, please talk with your doctor. Your doctor will ask how long and how often you have been experiencing the symptom(s), in addition to other questions. This is to help figure out the cause of the problem, called a diagnosis.
If cancer is diagnosed, relieving symptoms remains an important part of cancer care and treatment. This may also be called symptom management, palliative care, or supportive care. Be sure to talk with your health care team about the symptoms you experience, including any new symptoms or a change in symptoms.
Doctors use many tests to find or diagnose, cancer. They also do tests to learn if cancer has spread to another part of the body from where it started. If this happens, it is called metastasis. For example, imaging tests can show if
For most types of cancer, a biopsy is the only sure way for the doctor to know whether an area of the body has cancer. In a biopsy, the doctor takes a small sample of tissue for testing in a laboratory. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis, but this situation is rare for prostate cancer. For example, a biopsy may not be done when a patient has another medical problem that makes it difficult to do a biopsy, or when a person has a very high PSA level and a bone scan that indicates cancer.
This list describes options for diagnosing this type of cancer. Not all tests listed below are commonly used for every person. Your doctor may consider these factors when choosing a diagnostic test
-Your signs and symptoms
-Your age and medical condition
-The results of earlier medical tests
In addition to a physical examination, the following tests may be used to diagnose prostate cancer:
- PSA test. As described in the Introduction and Screening sections, PSA is a type of protein released by prostate tissue that is found in higher levels in a man’s blood. Levels can be raised when there is abnormal activity in the prostate, including prostate cancer, BPH, or inflammation of the prostate. Doctors can look at features of the PSA value, such as absolute level, change over time (also known as “PSA velocity”), and level in relation to prostate size, to decide if a biopsy is needed.
- Free PSA test. There is a version of the PSA test that allows the doctor to measure a specific component, called the “free” PSA. Free PSA is found in the bloodstream and is not bound to proteins. A standard PSA test measures total PSA, which includes both PSA that is and is not bound to proteins. The free PSA test measures the ratio of free PSA to total PSA. Knowing this ratio can sometimes help find out if an elevated PSA level is caused by a malignant condition like prostate cancer.
- DRE. A doctor uses a DRE to find abnormal parts of the prostate by feeling the area using a finger. It is not very precise and not every doctor has expertise in the technique; therefore, DRE does not usually detect early prostate cancer. See the Screening section for more information.
- Biomarker tests. A biomarker is a substance that is found in the blood, urine, or body tissues of a person with cancer. It is made by the tumor or by the body in response to the cancer. A biomarker may also be called a tumor marker. Biomarker tests for prostate cancer include the 4Kscore, which predicts the chances a man will develop high-risk prostate cancer, and the Prostate Health Index (PHI), which predicts the chances a man will develop prostate cancer.
Confirming the diagnosis
If the PSA or DRE test results are abnormal, then the following tests can help confirm a diagnosis of cancer:
- PCA3 test. The Prostate CAncer gene 3 (PCA3) assay looks for the PCA3 gene in a man’s urine. Unlike PSA, which can be found in anyone with a prostate, the PCA3 gene is greatly expressed in men with prostate cancer. Using a urine test, a doctor can find out whether this gene is present in the body. This test does not replace PSA. It is used along with a PSA test to help decide if a prostate biopsy is needed.
- Transrectal ultrasound (TRUS). A doctor inserts a probe into the rectum that takes a picture of the prostate using sound waves that bounce off the prostate. A TRUS is usually done at the same time as a biopsy.
- Biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis. To get a tissue sample, a surgeon most often uses TRUS and a biopsy tool to take very small slivers of prostate tissue. Biopsy specimens will be taken from several areas of the prostate. This is done to ensure that a good sample is taken for examination. Most men will have 12 to 14 pieces of tissue removed, and the procedure can take 20 to 30 minutes to complete. A person usually can have this procedure done at the hospital or doctor’s office without needing to stay overnight. The patient is given local anesthesia beforehand to numb the area and usually receives antibiotics before the procedure to prevent infection. A pathologist then analyzes the sample(s) under a microscope. A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease. Ask to review the results of the pathology report with your health care team.
- MRI fusion biopsy. An MRI fusion biopsy combines an MRI scan with TRUS. Evaluation with a prostate MRI scan has become a routine procedure in clinical practice. The patient first receives an MRI scan to identify suspicious areas of the prostate that require further evaluation. The patient then has an ultrasound of the prostate. Computer software combines these images to produce a 3D image that helps target the precise area where to perform the biopsy. Although it may not eliminate the need for repeat biopsies, an MRI fusion biopsy can better identify areas that are more likely to be cancerous than other methods. An MRI fusion biopsy should only be performed by someone with expertise in the procedure.
Early screening and detection can allow for early treatment, this is what makes coming in and having your PSA levels checked regularly. If you are experiencing any of the above symptoms call any one of our offices; Uptown Dallas, Downtown Fort Worth or Keller, to make an appointment at 817-345-0303.
All information sited from www.cancer.net. where you can find more information.