Prostate Cancer Diagnosis and Treatment

Generally, men in their 50s should receive prostate screening, especially when risk factors are involved. There are two common tests for diagnosing prostate cancer. Depending on the results of the diagnosis, additional testing may occur to determine the best treatment plan to combat the disease. 

Diagnosing Prostate Cancer

Doctors may use two initial testing procedures to look for prostate cancer. 

The first, digital rectal exam (DRE), involves an examination of the prostate for hard or lumpy areas. The doctor inserts his or her finger through the rectum and examines the prostate for any abnormalities, which may require additional testing.

A PSA (prostate-specific antigen) test is the second procedure if abnormalities are found during the DRE. A urology specialist takes a blood sample to analyze and determine if a high amount of PSA is in the bloodstream. If so, this may indicate inflammation, enlargement, prostate infection or cancer.

An enlarged prostate could be a sign of benign prostatic hyperplasia (BPH), which occurs in most men as they age. The symptoms of BPH may include frequent urination or urine retention. The following tests can reveal BPH rather than prostate cancer.

Testing

Detecting abnormalities during the DRE or PSA tests may lead to additional testing.

A prostate ultrasound provides further evaluation of the prostate. Using a small probe, doctors can capture pictures of the prostate gland. These images represent different angles of the prostate gland to further detect abnormalities.

A follow-up test – prostate biopsy – is a collection of sample tissues that are analyzed to locate cancer cells. Once the biopsy confirms prostate cancer is present, the next step is to determine its aggressiveness.

The cancer cells are compared to healthy cells, which allow doctors to assign a grade. The Gleason scale is commonly used to evaluate the grade of cancer cells. The scale ranges from two – nonaggressive – to 10, which is considered very aggressive.

Assigning a grade and determining how far the prostate cancer has spread helps in developing a treatment plan.

Treatment

Treatments for prostate cancer vary and depend on the aggressiveness of the disease. Generally, prostate cancer does not cause erectile dysfunction; however, some treatments can lead to hormonal changes that affect a man’s sex life.

There are two forms of radiation therapy in prostate cancer treatment. One, known as an external beam radiation, occurs outside the body. Brachytherapy is internal, where the doctor implants radioactive seeds into the cancer tumors.

The goal of hormone therapy is to stop the production of testosterone, which can cause cancer cells to grow. Hormone therapy consists of different types of medications and surgery.

Medications that stop the body from producing testosterone include LH-RH, or luteinizing hormone-releasing hormone. Anti-androgens can block testosterone before it reaches the prostate cancer cells. By removing the testicles, doctors can reduce testosterone levels.

Another surgical procedure is a radical prostatectomy. This involves removing the prostate gland and surrounding tissue, along with some lymph nodes. Surgery may require an incision in the abdomen or between the anus and scrotum.