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Testing for Prostate Cancer

Testing for Prostate Cancer

Testing. Testing. Testing. –
Visiting the Doctor for a Diagnosis

Initial Prostate Cancer Testing1

Having signs and symptoms are clues that something may be wrong – but is it cancer? This is where getting a diagnosis from your doctor is important. A diagnosis is the act of identifying a disease or problem. It may take a number of tests, talks with doctors, and examinations to get to a clear diagnosis—and this can be frustrating. If you have advanced prostate cancer, your doctor will want to find out exactly where the cancer has spread.

Here are some of the tests used to diagnose prostate cancer:

Digital Rectal Exam (DRE):

Using a gloved finger in the rectum, a doctor feels the prostate for any changes in size or shape. A DRE is a good way to check the prostate area around the rectum, where most prostate cancers grow.

Prostate-Specific Antigen (PSA):

The PSA is a protein that is produced by the prostate gland and is found circulating in your bloodstream. When there are higher levels of PSA than normal, or when there is a dramatic increase in PSA levels in the body, this could signal a problem with the prostate.

If the above-mentioned tests give results that seem suspicious, your doctor may want to do further testing that involves taking images of your prostate or taking samples from your body:

Transrectal Ultrasound (TRUS):

This technology uses high frequency sound waves to take images of your prostate through the rectum. A TRUS can help a doctor look at your prostate to see if there is anything abnormal in shape or size.

Biopsy

If prostate cancer is suspected, your doctor may want to take a sample of tissues or cells from your body to have them tested in a lab. There are a few different ways to take tissue or cell samples, and they are listed below:

  • Transrectal Biopsy: A thin needle is inserted through the rectum and into the prostate. From there, the needle takes a collection of cells from your prostate gland.
  • Transperineal Biopsy: A needle is inserted in the area between your rectum and your scrotum (the perineum). The needle can collect a sample from your prostate via the perineum.

Metastatic (Advanced) Prostate Cancer Testing1-4

If you have been diagnosed with prostate cancer, your doctor may want to find out if it has spread. To learn whether the cancer has spread beyond the prostate, your doctor may want to order these tests:

Bone Scan:

As the name suggests, this test looks at your bones for the presence of cancer cells. A bone scan is done in the hospital. A radioactive substance (called a “tracer”) is injected into a vein in your arm. This tracer will travel through your bloodstream and into your bones to areas of fast bone growth or repair.. A special camera is able to take pictures of your bones and show where these “hot spots” or bone problems are. Hot spots may point to problems such as arthritis, a tumour, a fracture, or an infection.

  • When is a bone scan used? Typically bone scans are done on men whose prostate cancer may have spread; men who report bone pain; men with a high Gleason score or PSA level.

Magnetic Resonance Imaging (MRI)

An MRI is another technology that is used to capture pictures of the body from “the inside”. An MRI can show your doctor three-dimensional images of things like your organs, tissues, bones,blood vessels and if the cancer has spread to the lymph nodes or near by tissues or organs. Like the bone scan, an MRI is done in the hospital. You will have a special dye injected into your vein that is used to help identify areas where there may be tumours.

Computerized Axial Tomography (CAT or CT) Scan

This scan is a kind of computerized x-ray. It shows your doctor very detailed pictures of your body’s organs, tissues, bones and blood vessels.

  • When is a CT scan used? Typically, CT scans are used for men with a high Gleason Score and a high PSA level. They are used to detect whether cancer has spread to the lymph nodes around the prostate.

References

  1. Canadian Cancer Society. Diagnosing prostate cancer. Online. Available at
    http://www.cancer.ca/en/cancer-information/cancer-type/prostate/diagnosis/?region=on
  2. The Prostate Centre at The Princess Margaret. MRI. Online. Available
    http://www.prostatecentre.ca/index.php/prostate-cancer/diagnosing-cancer/mri
  3. The Prostate Centre at The Princess Margaret. CT Scan. Online. Available at
    http://www.prostatecentre.ca/index.php/prostate-cancer/diagnosing-cancer/ct-scan
  4. WebMD. Bone Scan. 2012 Online Available:
    www.webmd.com/a-to-z-guides/bone-scan

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