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Diagnosis Of Prostate Cancer |
By:
Fritz Frei |
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The diagnosis of prostate cancer can be made on clinical
suspicion of the disease, following screening, or as an
incidental finding during transurethral resection for suspected
benign disease (TURP).
Clinically suspected prostate cancer Prostate cancer can be
completely asymptomatic or present with symptoms similar to
benign prostatic enlargement (see symptoms). It can also present
with the symptoms of metastatic disease. On digital rectal
examination prostate cancer feels rock hard and nodular.
Invasion into the surrounding structures may be palpable as a
hard mass. Spread to the lymph glands may be palpable in the
groins or pelvis. Bony metastases to the lumbar spine or pelvis
are often tender to palpation. PSA (Prostate Specific Antigen)
is a substance excreted by all prostate cells. The blood level
of PSA is elevated in prostate cancer and the level of elevation
correlates with the extent of disease. The PSA level can also be
elevated by benign diseases such as prostatitis and benign
prostatic hyperplasia. The normal range for PSA is 0 - 4 ng/ml.
The higher the PSA the greater is the chance of having prostate
cancer. Somebody with a PSA of 4 - 10 ng/ml has a 25% chance of
having prostate cancer, while a PSA of greater than 10 carries a
50% risk of the disease. Very high levels of PSA (>100ng/ml)
almost invariably indicate widespread metastatic disease. The
diagnosis of prostate cancer is confirmed by needle biopsy and
histological analysis of the biopsy specimens. A transrectal
ultrasound scan is performed via a probe inserted into the
rectum, and ultrasound guided needle biopsies of the prostate
are taken. The procedure is performed under local anaesthetic
Screening All healthy men over the age of 50 years should have
annual prostate cancer checks. Black men and men with a positive
family history should start at age 40. The aim of screening is
to diagnose the disease at an early stage while it is still
potentially curable. By the time prostate cancer becomes
symptomatic it is usually beyond cure. The screening tests
consist of a digital rectal examination and a PSA blood test.
The prostate gland may feel entirely normal despite the presence
of an early cancer. The combination of PSA and digital rectal
examination is more sensitive than either test alone. If one or
both of these tests are abnormal a transrectal ultrasound and
needle biopsies of the prostate gland are performed.
Incidental finding following TURP Whenever a transurethral
resection of the prostate gland is performed for suspected
benign disease the removed tissue is sent for histological
analysis. Occasionally evidence of unsuspected prostate cancer
is found in the tissue. In a young man with an otherwise long
life expectancy this is obviously significant. A tiny focus of
cancer in an elderly man is probably not significant, since the
prostate cancer will not have sufficient time to become
bothersome.
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Health-Service-Online Fritz Frei Admin
http://www.cancer-info.info
info@cancer-info.info
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Article Source: http://www.PopularArticles.com/article10198.html |
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