Diagnosing Prostate Cancer

Although there are a number of excellent tests to indicate the possible presence of prostate cancer, such as digital rectal examination and prostate specific antigen (PSA) blood, the only way to diagnose the presence of cancer prostate cancer is a biopsy of the prostate.

A biopsy is usually performed by a urologist and can be done as an 'office' procedure. There are various ways in which a biopsy can be taken, but it is common to start by taking a transrectal ultrasound. Here an instrument is inserted into the rectum and sound waves are used to produce a computer image of the prostate. With this picture in the hand of the doctor may use a hollow needle to take several small samples of prostate tissue in microscopic examination. Most patients say that the biopsy is not a particularly painful procedure, but you'll probably have a tingling sensation.

The areas in which samples are taken, and the number of samples for testing will depend on the reason for the biopsy. For example, if the biopsy is simply in response to rising levels of PSA, then a half-dozen or more samples can be collected from different areas of the prostate. However, if the biopsy is done to examine a particular area, abnormal prostate samples, so only two or three can be collected.

Once the samples have been collected, they will be examined by a pathologist. normal cells of the prostate are usually a standard size and neatly arranged in a recognizable pattern. However, prostate cancer cells normally vary in size and are irregular in shape.

If the pathologist determines that the cancer is found, it will go to class to indicate whether the cancer is a low-grade cancer is likely to grow slowly, or high-grade cancer that could well be aggressive and spread rapidly.

In 1977, the pathologist Donald Gleason devised a scale for classifying prostate cancer and this scale is now widely used today. The Gleason scale from 1 to 5 (1 representing a low-grade cancer, and 5 high grade cancer) and a score is assigned to each of two samples from the largest areas of cancer with the grades being added to produce a final Gleason score.

A Gleason score of 2 to 4 is considered low and indicates a cancer, by age of patient, may now pose a significant threat during the patient's life. A score between 5 and 7 is an intermediate grade for which the treatment can often stop the disease in its tracks. Once a Gleason score of 8 cancer is said to be aggressive and may spread outside the prostate, even if it has not already.

Testing the possible presence of prostate cancer is recommended for all men aged over 50 and men aged over 40 who are entering a high risk category. It is important to remember that prostate cancer is suspected after a biopsy is performed to confirm its presence so that treatment can be given.