HERC

detecting prostate cancer

Currently, there are two main tests that are used to detect prostate cancer:

The prostate-specific antigen (PSA) blood test

The PSA test measures the amount of a protein in the blood called the prostate-specific antigen.  If elevated, this might indicate the presence of cancer.

"Normal" PSA levels range from zero to 4.0 ng/ml (nanograms per milliliter).  Levels between 4.0 and 10.0 are considered "borderline," and levels over 10.0 are considered "high." 

Please note: PSA results only estimate the likelihood of prostate cancer.  Although the test is very good, men with borderline or high results have been found not to have prostate cancer, and men with normal results have been diagnosed with prostate cancer.

The digital rectal exam (DRE)

In a DRE, the doctor inserts a gloved finger into the rectum and probes the prostate gland to determine if there are any irregularities.

The DRE, together with the PSA, increases the chance of detecting prostate cancer early. 

Confirming the Diagnosis of Prostate Cancer

If your doctor suspects from the PSA or DRE that you may have prostate cancer, he or she may suggest a biopsy. A diagnosis of prostate cancer is usually confirmed by a biopsy of the prostate gland.

A biopsy is a surgical procedure in which small samples of prostate tissue are removed & examined under a microscope. The procedure can be done in the physician's office. Actual biopsies take seconds; the whole procedure will take a little less than half an hour. Most of this time is for getting the individual ready for the procedure.

To perform the biopsy, a thin needle is inserted through the wall of the rectum into the area of the prostate gland that appears abnormal or suspicious, Placement of the needle is guided by the physician's finger or a device called a transrectal ultrasound. When the needle reaches its target, a small amount of tissue is collected. The tissue sample is sent to the laboratory. If cancer is detected, additional tests will be done to determine the stage of the disease.

The stage of the cancer indicates whether the tumor is confined to the prostate gland or if it has spread to other parts of the body.

The grade of the cancer is also important. Grade helps determine whether it is likely to be aggressive (fast growing with a tendency to spread) or, slow growing.

TNM Staging System

The TNM staging system helps to determine the extent of spread of cancer. It is very important to know the stage of the cancer for selecting the appropriate treatment.

  • T for tumor size and whether it has invaded nearby tissue
  • N for which lymph nodes that are involved
  • M for metastasis (spread of cancer from one body part to another).

Ask your health provider to clearly explain their stage so you can make an informed decision about each treatment option .

Our Recommendation:

Men at a higher risk for prostate cancer start testing at age 40.

Men in the high-risk group include: African Americans and those with a family history of prostate cancer. 

At age 50, all other men should talk to their health care provider about having annual prostate exams that consists of the prostate-specific antigen (PSA) blood testing & digital rectal exams (DRE).