Prostate Cancer Detection
After a patient visits their doctor about prostate problems, the next step is the possibility of ruling out prostate cancer based on the individual’s symptoms.
African American males have a higher rate of prostate cancer diagnosed and unfortunately a high mortality rate from prostate cancer.
From the opinion of many doctors and researchers, prostate cancer starts with Prostatic Intraepithelial Neoplasia(PIN). PIN is a condition that manipulates the structure of the prostate gland cells. PIN is documented to begin around the age of 20. Most cases of prostate cancer originate in the glandular cells. Glandular cells involve the secretion of seminal fluid.
It has been reported that men over 50 have a 50% chance of having PIN. If the cancer has been located in the local area (only in the prostate area), the survival rate is nearly 100%. If the cancer is located in the regional area (the cancer is seen in other areas), then the survival rate is about 34%.
Early symptoms of prostate cancer usually go undetected unless the individual has experienced problems with urinary tract issues. Sometimes, the problems with the urinary tract may not indicate prostate cancer but a condition with the prostate called “Benign Prostatic Hyperplasia (BPH)”. BPH can affect all males but there are higher cases reported in older males because the prostate can enlarge to affect the proper functioning of the opening of the urethra.
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An advanced case of prostate cancer could cause blood(hematuria) to be found in the urine. Hematuria can be associated with other diseases so doctors look for more clues to diagnosis problems with the prostate. Other symptoms include: bone pain (the cancer has spread throughout the bony areas-hips, spine, and ribs). Prostate cancer affecting the spine can cause loss of bladder and bowel control and muscle weakness.
If the doctor suspects a problem with the prostate, the doctor may perform a PSA test or a digital rectal exam. The PSA (prostate-specific antigen) is a blood test for measuring the prostate antigen in the patient’s blood. The digital rectal exam is a test that examines the prostate through the rectum. Normally, men have a PSA level of 4 or lower. If the number is above 4, then a prostate biopsy is ordered.
The most widely used method to detect prostate cancer is the core needle biopsy. Under the care of an urologist, a needle is inserted into the prostate and extracts tissues cells from the prostate. Depending on the doctor, there can be up to several tissue samples taken. Once the samples are obtained, the samples are sent to the lab for analysis. Sometimes if there are too many samples taken, it may miss areas where cancer cells may have been located. This creates a “false negative report.”
If cancer is found in the biopsy sample(s), then the sample is graded. The grading system is called the “Gleason grade.” The 1-5 grading system determines the change in the prostate cancer cells. Level 1 is normal. Levels 2-4 represent different features. Level 5 is graded as a tumor. Sometimes if several areas are involved, the level may be graded as a 2-4 depending on multiple areas of the sample.
After tests(x-rays, bone scans, MRI’s), the cancer is staged. There are four stages of Prostate Cancer-Stage 1, 2, 3, and 4. Each stage has a sub component based on the TNM system. The TNM system is (T) tumor, (N) surrounding lymph nodes and (M) no evidence of mestastasis.
Another staging system called the “Whitmore-Jewett system” was used before the TNM system. The system stage the cancer levels as A, B, C, and D.
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