Understanding Prostate Cancer -- Diagnosis & Treatment
How Do I Know If I Have Prostate Cancer?
The best way to detect prostate cancer in its early stages is with regular digital (rectal) prostate exams and the prostate specific antigen (PSA) blood test. Because most malignant prostate tumors originate in the part of the gland nearest the rectum, many cancers can be detected during routine rectal exams. Many doctors recommend an annual rectal exam, supplemented by a PSA blood test, starting at age 50 for most men. The screenings are recommended beginning at age 40 to 45 for African Americans and those with a family history of prostate cancer.
PSA is a specific type of protein that is elevated in the blood if there is cancer present, making it a valuable tool in detecting early prostate cancer. However, the PSA levels can also be elevated when there is prostate inflammation, urinary retention, prostate infection, benign prostatic hypertrophy (BPH), and prostate manipulation. Despite this, digital rectal exams and PSA tests are the two screening measures that offer the best chance of detecting prostate cancer while it is localized and most treatable. Prostate cancer may also be discovered incidentally during treatment for other urinary problems. Because of the possibility of a false-positive PSA reading, it is important to discuss this test with your doctor before having one. An elevated PSA does not mean that you have cancer; a normal PSA level (0 to 4) does not mean you don't have cancer. However, 15% of men with a PSA of 2.6 or greater will have prostate cancer.
Alternative Treatments for Prostate Cancer
After non-melanoma skin cancer, prostate cancer is the most commonly diagnosed cancer in American men. It's also highly treatable if caught early. For many men, though, the standard treatments for prostate cancer -- medication, radiation, and surgery -- often come with unwanted side effects. Because of those side effects, some men wonder if alternative treatments might be beneficial. Is it possible such remedies as herbs and natural dietary supplements might help treat prostate cancer? Could na...
Read the Alternative Treatments for Prostate Cancer article > >
New information has shown that although prostate cancer screening may detect prostate cancer earlier, routine screening for prostate cancer does not improve long-term survival from prostate cancer.
If routine screening arouses suspicion and/or PSA levels are elevated, a doctor will perform biopsies of the prostate guided by an ultrasound instrument inserted in the rectum (transrectal ultrasound) or by a cytoscope, a narrow telescope passed through the urethra. Tissue samples will be examined for cancer cells. In order to determine if the cancer has spread outside the prostate gland, abdominal and pelvic X-rays will be ordered. CT scans, a bone scan and chest X-ray may be ordered, usually for men with prostate cancer and a PSA of 20 or greater.
For men who have persistently elevated PSA levels, but negative biopsies, there is a new urine test known as a PCA-3. This test is performed after a digital rectal exam and measures a PSA product called DD3. It prevents the need for repeat biopsies in some men. A test in development at Johns Hopkins University, called EPCA-2, detects a protein linked to prostate cancer. The test is proving to be a more sensitive test for detecting prostate cancer, even in men with normal PSA levels or BPH. This test also predicts cancer that has extended beyond the prostate capsule.
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