Prostate Cancer Diagnosis:
If this happens, it is called a transfer. For example, an imaging test can show if cancer has spread. The imaging test shows a picture inside the body. Doctors can also do tests to see which treatment works best.
For most types of cancer, a biopsy is the only reliable way for doctors to understand whether a part of the body has cancer. In a biopsy, doctors take a small number of tissue samples in the laboratory for testing.
If a biopsy is not possible, the doctor may recommend other tests that are helpful for diagnosis, but this is rare for prostate cancer. For example, when a patient has another medical problem that makes it difficult to perform a biopsy, or when the patient has a very high PSA level and a bone scan indicating cancer, a biopsy may not be performed.
This list describes the options for diagnosing such cancers. Not all of the tests listed below apply to everyone. Your doctor may consider these factors when choosing a diagnostic test:
- Suspected to be the type of cancer
- Your symptoms and signs
- Your age and health
- Results of early medical examination
Preliminary Test For Prostate Cancer Diagnosis :
In addition to physical examination, the following tests can be used to diagnose prostate cancer:
As described in the Introduction and Screening section, PSA is a protein released from prostate tissue that is high in human blood. When there is abnormal activity in the prostate, the level can be increased, including prostate cancer, BPH or prostatitis.
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The physician can view the characteristics of the PSA values, such as absolute levels, changes over time (also known as “PSA speed“), and levels associated with prostate size to determine if a biopsy is needed.
Free PSA test:
There is a version of the PSA test that allows doctors to measure a specific component called a free PSA. Free PSA is present in the blood and does not bind to proteins.
The standard PSA test measures the total PSA, which includes PSA bound to the protein and not bound to the protein. The free PSA test measures the ratio of free PSA to total PSA.
Knowing this ratio can sometimes help determine if elevated PSA levels are caused by malignant diseases such as prostate cancer.
The doctor uses the DRE to find an abnormal part of the prostate by sensing the area with his fingers. It’s not very precise, not every doctor has expertise in this area; therefore, DRE usually does not detect early prostate cancer.
A biomarker is a substance found in the blood, urine or body tissues of a person with cancer. It responds to cancer by a tumor or body. Biomarkers can also be referred to as tumor markers.
Biomarker testing for prostate cancer includes a 4Kscore predicting the chances of men with high-risk prostate cancer, and a prostate health index (PHI) predicting the likelihood of men suffering from prostate cancer.
If the PSA or DRE test results are abnormal, the following tests can help confirm the diagnosis of cancer:
Prostate cancer gene 3 (PCA3) detects the PCA3 gene in human urine. Like PSA, the PCA3 gene can be found in men with prostate cancer.
Using a urine test, the doctor can find out if the gene is present in the body. This test does not replace the PSA. It is used in conjunction with PSA testing to help determine if a prostate biopsy is needed.
Transrectal Ultrasound (TRUS):
The doctor inserts the probe into the rectum and takes a picture of the prostate using sound waves that bounce off the prostate. TRUS is usually performed concurrently with biopsy.
The biopsy is performed by removing a small amount of tissue under the microscope. Other tests may indicate the presence of cancer, but only a biopsy can confirm the diagnosis.
To obtain tissue samples, surgeons most often use TRUS and biopsy tools to shoot very small prostate tissue. Biopsy specimens will be taken from several areas of the prostate.
This is done to ensure that samples are taken for inspection. Most men will remove 12 to 14 pieces of tissue and the process may take 20 to 30 minutes to complete.
A person can usually complete this procedure in a hospital or doctor’s office without having to stay overnight.
The patient is pre-existing with local anesthesia to anesthetize the area and usually receives antibiotics to prevent infection prior to surgery.
The pathologist then analyzes the sample under the microscope. A pathologist is a doctor who specializes in interpreting cells and examining cells, tissues, and organs to diagnose diseases.
Ask to review the results of the pathology report with your medical team.
MRI Fusion Biopsyto For Prostate Cancer Diagnosis:
MRI fusion biopsy combined with MRI scan and TRUS. Evaluation of prostate MRI scans has become a routine procedure in clinical practice.
The patient first underwent an MRI scan to identify suspicious areas of the prostate that require further evaluation. The patient is then examined for a prostate ultrasound.
The computer software combines the images together to produce a 3D image that helps determine the precise area in which the biopsy is performed.
Although the need for repeated biopsy may not be eliminated, MRI fusion biopsy can better identify areas that are more likely to become cancerous than other methods.
Find Out If Cancer Has Spread:
To determine if cancer has spread beyond the prostate, the doctor may perform the imaging tests listed below.
Doctors can estimate the risk of transmission based on PSA levels, tumor grade, and other factors, called metastases, but imaging tests can confirm this.
Men with low-risk early-stage prostate cancer without any symptoms do not need to undergo a CT scan or a bone scan to determine the stage of the disease.
Learn more about when to recommend these tests to see if cancer has spread.
Whole-body bone scan. The bone scan used a radiotracer (Technetium-99) to observe the inside of the bone. The tracer is injected into the vein of the patient.
It collects areas of the bone where the metabolic activity takes place. Healthy bones appear gray in the camera, and injured areas (such as those caused by cancer) look dark.
It is important to know that structural changes in the bone, such as arthritis or fractures such as old fractures, can also be interpreted as abnormalities that need to be evaluated by a doctor to ensure they are not cancer.
Computed Tomography (CT or CAT) Scan:
The CT scan creates a 3D image of the inside of the body using X-rays taken from different angles. The computer combines these images into a detailed cross-sectional view showing any abnormalities or tumors.
CT scans can be used to measure the size of the tumor. Sometimes a special dye called contrast agent is given before scanning to provide better image detail. This dye can be injected into the patient’s vein or swallowed as a liquid.
Positron Emission Tomography (PET) or PET-CT Scanning:
PET scans are often combined with CT scans (see above) and are referred to as PET-CT scans. However, you may hear a doctor refer to this process as a PET scan. PET scanning is a method of creating images of organs and tissues in the body.
A small amount of radioactive material is injected into the patient. This substance is absorbed by cells that use the most energy. Because cancer tends to use energy actively, it absorbs more radioactive material.
The substance is then detected by the scanner to produce an image of the interior of the body. For many types of cancer, PET-CT scans use fluorodeoxyglucose (FDG) as the imaging material; however, FDG is not a useful substance for prostate cancer imaging and should not be used.
Researchers are actively investigating the use of different substances for PET scans to detect prostate cancer.
For example, sodium fluoride is absorbed by the bone and its use in PET scans increases the chances of finding prostate cancer that has spread to the bone.
Other substances studied included choline acetate, fluciclovine and prostate-specific membrane antigen (PSMA).
Magnetic Resonance Imaging (MRI):
MRI scans use magnetic fields instead of X-rays to produce detailed images of the body. MRI can be used to measure the size of a tumor.
A special dye called a contrast agent is given prior to scanning to produce a sharper image. This dye can be injected into the patient’s vein or swallowed as a liquid.
After completing the diagnostic test, the doctor will check with you all the results. If prostate cancer diagnosed, these results also help doctors describe cancer. This is called staging.