Prostate cancer symptoms, diagnosis and treatment
How do I know if I have prostate cancer?
Prostate cancer usually grows slowly, so it can be many years before symptoms are noticed.
Prostate cancer symptoms include needing to urinate more often, straining while urinating and feeling that the bladder isn't fully empty.
Many cases of prostate cancer are detected in their early stages by digital rectal examination (DRE) or a PSA blood test. Because most malignant prostate tumours originate in the part of the gland nearest the rectum, many cancers can be detected during rectal examinations. Men who are worried about their risk of prostate cancer can ask their doctor for a PSA test supplemented by a digital rectal examination. Some doctors think that testing is a good idea for most men after age 50, or from age 40 or 45 for men at high risk, such as black men and those with a family history of prostate cancer.
PSA is a protein whose blood level tends to increase in the presence of prostate cancer, making it useful in detecting early prostate cancer. However, levels may also be raised in other prostate conditions that are not cancer. Prostate cancer may also be discovered incidentally during treatment for 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. Rather, it raises questions that need to be addressed and explained. There are a number of causes of an elevated PSA, and cancer is only one of them.
If a digital rectal examination arouses suspicion and/or PSA levels are elevated, a doctor may perform biopsies of the prostate guided by an ultrasound instrument inserted in your rectum (transrectal ultrasound, TRUS). X-rays of the urinary tract, along with blood and urine studies, may also be performed to assist diagnosis. Performing a biopsy will confirm whether or not cancer is present. Guided by ultrasound images, the doctor inserts a needle into the prostate and extracts small slivers of tissue from the suspicious area. Sometimes biopsies are instead obtained through a cystoscope, a narrow telescope passed through the urethra. A pathologist then studies the sample under a microscope to determine whether cancer cells are present. In order to determine if the cancer has spread outside the prostate gland, doctors may arrange CT scans, bone scans, chest X-rays, or other imaging tests.
What are the treatments for prostate cancer?
Since prostate cancer is often slow growing and may not be fatal in many men, some men - after discussing the options with their doctors - opt for watchful waiting. This involves monitoring the prostate cancer for signs that it is becoming more aggressive but otherwise not treating it. This approach is recommended more commonly for men who are older or suffer from other life-threatening conditions. In these cases, the cancer may be growing so slowly that it's not likely to be fatal.