Diagnosis of Prostate Cancer
Diagnostic Test list for Prostate Cancer:
The list of medical tests
mentioned in various sources as
used in the diagnosis of Prostate Cancer
includes:
Prostate Cancer Diagnosis: Book Excerpts
Tests and diagnosis discussion for Prostate Cancer:
Prostate Problems - Age Page - Health Information: NIA (Excerpt)
To find the cause of prostate
symptoms, the doctor takes a careful medical history and performs a
physical exam. The physical includes a digital rectal exam, in which
the doctor feels the prostate through the rectum. Hard or lumpy
areas may mean that cancer is present.
Some doctors also
recommend a blood test for a substance called prostate specific
antigen (PSA). PSA levels may be high in men who have prostate
cancer or BPH. However, the test is not always accurate. Researchers
are studying changes in PSA levels over time to learn whether the
test may someday be useful for early diagnosis of prostate
cancer.
If a doctor suspects prostate cancer, he or she may recommend a
biopsy. This is a simple surgical procedure in which a small piece
of prostate tissue is removed with a needle and examined under a
microscope. If the biopsy shows prostate cancer, other tests are
done to determine the type of treatment needed. (Source: excerpt from Prostate Problems - Age Page - Health Information: NIA)
What You Need To Know About Prostate Cancer: NCI (Excerpt)
These tests are used to detect prostate
abnormalities, but they cannot show whether abnormalities are
cancer or another, less serious condition. The doctor will
take the results into account in deciding whether to check the
patient further for signs of cancer. The doctor can explain
more about each test.
-
Digital
rectal exam -- the doctor inserts a lubricated,
gloved finger into the rectum and feels the prostate through
the rectal wall to check for hard or lumpy areas.
-
Blood test for prostate-specific
antigen (PSA) -- a lab measures the levels of
PSA in a blood sample. The level of PSA may rise in men who
have prostate cancer, BPH, or infection in the
prostate.
(Source: excerpt from
What You Need To Know About Prostate Cancer: NCI)
What You Need To Know About Prostate Cancer: NCI (Excerpt)
If a man has symptoms or test results that suggest prostate
cancer, his doctor asks about his personal and family medical
history, performs a physical exam, and may order laboratory
tests. The exams and tests may include a digital rectal exam,
a urine test to check for blood or infection, and a blood test
to measure PSA. In some cases, the doctor also may check the
level of prostatic
acid phosphatase (PAP) in the blood, especially if the
results of the PSA indicate there might be a problem.
The doctor may order exams to learn more about the cause of
the symptoms. These may include:
-
Transrectal ultrasonography
-- sound waves that cannot be heard by humans (ultrasound)
are sent out by a probe inserted into the rectum. The waves
bounce off the prostate, and a computer uses the echoes to
create a picture called a sonogram .
-
Intravenous
pyelogram -- a series of x-rays of the organs of
the urinary tract.
-
Cystoscopy
-- a procedure in which a doctor looks into the urethra and
bladder through a thin, lighted tube.
Biopsy
If test results suggest that cancer may be present, the man
will need to have a biopsy .
During a biopsy, the doctor removes tissue samples from the
prostate, usually with a needle. A pathologist
looks at the tissue under a microscope to check for cancer
cells. If cancer is present, the pathologist usually reports
the grade
of the tumor. The grade tells how much the tumor tissue
differs from normal prostate tissue and suggests how fast the
tumor is likely to grow. One way of grading prostate cancer,
called the Gleason system, uses scores of 2 to 10. Another
system uses G1 through G4. Tumors with higher scores or grades
are more likely to grow and spread than tumors with lower
scores. (Source: excerpt from What You Need To Know About Prostate Cancer: NCI)
Diagnosis of Prostate Cancer: medical news summaries:
The following medical news items
are relevant to diagnosis and misdiagnosis issues for Prostate Cancer:
Diagnostic Tests for Prostate Cancer: Online Medical Books
16 MEDICAL BOOKS ONLINE!
Review excerpts from medical books online, free, without registration,
for more information about diagnostis of Prostate Cancer.
PROSTATIC MASS OR ENLARGEMENT:
Approach to the Diagnosis
(Differential Diagnosis in Primary Care)
The main consideration in diagnosing a prostatic mass is to rule out carcinoma. It is therefore wise to draw blood for PSA before proceeding in anyone that is suspected of prostate cancer. If the mass is located in the posterior lobes, there is further support for the diagnosis. Ultrasonography can be done for further localization before proceeding with a biopsy. Obviously, if the PSA is positive, referral to a urologist is mandatory, although false-positives can occur in this test. A large, boggy prostate suggests a prostatic abscess or prostatitis. If there is no urethral discharge, one can elicit a discharge by prostatic massage. However, this should not be done if the patient has fever and significant tenderness of the prostate. It is better to proceed with antibiotic therapy and reexamine the patient after the fever has subsided. A smear and culture of the discharge is made. If upon examining the discharge under high-power microscopy, four or more WBCs per high-power field are found, the diagnosis of prostatitis can be made. If benign prostatic hypertrophy is suspected, cystoscopy and retrograde pyelography can be done.
» READ BOOK EXCERPT ONLINE »
Source: Differential Diagnosis in Primary Care, 2007
Prostatic cancer:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
A digital rectal examination that reveals a small, hard nodule may help diagnose prostatic cancer. The American Cancer Society advises a yearly digital examination for men older than age 40, a yearly blood test to detect prostate-specific antigen (PSA) in men older than age 50, and ultrasound if abnormal results are found.
CONFIRMING DIAGNOSIS A biopsy confirms the diagnosis of prostatic cancer. PSA levels will be elevated in all men with metastatic prostatic cancer. Serum acid phosphatase levels will be elevated in two-thirds of men with metastatic prostatic cancer.
Therapy aims to return the serum acid phosphatase level to normal; a subsequent rise points to recurrence. Magnetic resonance imaging, computed tomography scan, and excretory urography may also aid diagnosis.
Elevated alkaline phosphatase levels and a positive bone scan point to bone metastasis.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Benign prostatic hyperplasia:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
Clinical features and a rectal examination are usually sufficient for diagnosis. Other findings help to confirm it:
❑ Excretory urography may indicate urinary tract obstruction, hydronephrosis, calculi or tumors, and filling and emptying defects in the bladder.
❑ Elevated blood urea nitrogen and serum creatinine levels suggest renal dysfunction.
❑ Urinalysis and urine culture show hematuria, pyuria and, when the bacterial count exceeds 100,000/µl, urinary tract infection (UTI).
When symptoms are severe, a cystourethroscopy is definitive, but this test is performed only immediately before surgery to help determine the best procedure. It can show prostate enlargement, bladder wall changes, and a raised bladder.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Introduction: Malignant Neoplasms:
Diagnostic methods
(Professional Guide to Diseases (Eighth Edition))
A thorough medical history and physical examination should precede sophisticated diagnostic procedures. Useful tests for the early detection and staging of tumors include X-ray, endoscopy, isotope scan, computed tomography scan, and magnetic resonance imaging, but the single most important diagnostic tool is a biopsy for direct histologic study of tumor tissue. Biopsy tissue samples can be taken by curettage, fluid aspiration (pleural effusion), fine-needle aspiration biopsy (breast), dermal punch (skin or mouth), endoscopy (rectal polyps), and surgical excision (visceral tumors and nodes).
An important tumor marker, carcinoembryonic antigen (CEA), although not diagnostic by itself, can signal malignancies of the large bowel, stomach, pancreas, lungs, and breasts. CEA titers range from normal (less than 5 ng) to suspicious (5 to 10 ng) to suspect (over 10 ng). CEA serves many valuable purposes:
❑as a baseline during chemotherapy to evaluate the extent of tumor spread
❑to regulate drug dosage
❑to prognosticate after surgery or radiation
❑to detect tumor recurrence.
Although no more specific than CEA, alpha-fetoprotein — a fetal antigen uncommon in adults — can suggest testicular, ovarian, gastric, and hepatocellular cancers. Beta human chorionic gonadotropin may point to testicular cancer or choriocarcinoma. Other commonly used tumor markers include prostate-specific antigen to detect and monitor prostatic cancer, and CA-125, useful for monitoring ovarian, colorectal, and gastric cancers.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Prostatitis:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
Characteristic rectal examination findings suggest prostatitis. In many cases, a urine culture can identify the causative infectious organism.
CONFIRMING DIAGNOSIS A firm diagnosis depends on a comparison of urine cultures of specimens obtained by the Meares and Stamey technique. This test requires four specimens: one collected when the patient starts voiding (voided bladder one); another midstream; another after the patient stops voiding and the physician massages the prostate to produce secretions (expressed prostate secretions; and a final voided specimen. A significant increase in colony count in the prostatic specimens confirms prostatitis.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Malignant spinal neoplasms:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
❑Spinal and lumbosacral magnetic resonance imaging confirm spinal tumor.
❑ X-rays show distortions of the intervertebral foramina; changes in the vertebrae or collapsed areas in the vertebral body; and localized enlargement of the spinal canal, indicating an adjacent block.
❑ Myelography identifies the level of the lesion by outlining it if the tumor is causing partial obstruction; it shows anatomic relationship to the cord and the dura. If obstruction is complete, the injected dye can't flow past the tumor. (This study is dangerous if cord compression is nearly complete because withdrawal or escape of cerebrospinal fluid (CSF) will allow the tumor to exert greater pressure against the cord.)
❑ Radioisotope bone scan demonstrates metastatic invasion of the vertebrae by showing a characteristic increase in osteoblastic activity.
❑ Computed tomography scan shows cord compression and tumor location.
❑ Frozen section biopsy at surgery identifies the tissue type.
❑ Lumbar puncture may be normal, abnormal, or nonspecific. It may show clear yellow CSF as a result of increased protein levels if the flow is completely blocked. If the flow is partially blocked, protein levels rise, but the fluid is only slightly yellow in proportion to the CSF protein level. Cytology of the CSF may show malignant cells of metastatic carcinoma.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Prostate Abnormality:
Differential Overview
(Field Guide to Bedside Diagnosis)
❑ Benign prostatic hypertrophy
❑ Acute bacterial prostatitis
❑ Chronic prostatitis
❑ Adenocarcinoma
❑ Prostatic calculus
❑ Prostatic abscess
Diagnostic Approach
History helps in risk stratification: Men with a first degree relative with prostate cancer have a 2 to 3 fold increased incidence of prostate cancer. With 2 first degree relatives, this increases 5 to 8 fold.
The normal prostate is heart-shaped with a median raphe and a mass of 20 to 25 g. Carefully examine the posterior surfaces of the lateral lobes because this is where most prostate cancer originates. In screening for prostate cancer, digital rectal examination (DRE) looking for nodules, induration, or asymmetry may help to calibrate PSA values in the “gray zone” of 4 to 10. For example, a large gland may offer an explanation for a mildly elevated PSA, but a small gland or one with induration or asymmetry should heighten suspicion of prostate cancer. The positive predictive value for prostate cancer of an abnormal finding on DRE is 15% to 30%, increasing odds 1.5- to 2-fold. Because of low sensitivity, the value of a negative DRE to rule out prostate cancer is low. Men with an abnormality on DRE and a PSA ,4 still have a probability of prostate cancer of 12%, so biopsy is usually recommended. Examination followed by biopsy of any prostate nodule is the appropriate tactic because the clinical examination alone is not accurate enough in distinguishing benign causes from adenocarcinoma.
New suspicious findings on DRE in a patient with an initial negative baseline helps to select for aggressive tumors. Cancer found based on the first DRE has a 5 year prostate cancer mortality of 3% and 10 year mortality of 14%. Cancer found on a subsequent DRE has mortalities of 19% and 43% respectively.
» READ BOOK EXCERPT ONLINE »
Source: Field Guide to Bedside Diagnosis, 2007
Prostatic cancer:
Diagnosis
(Handbook of Diseases)
A digital rectal examination that reveals a small, hard nodule may help diagnose prostatic cancer. The American Cancer Society advises a yearly digital examination for men older than age 40, a yearly blood test to detect prostate-specific antigen (PSA) in men older than age 50, and ultrasonography if abnormal results are found.
Biopsy confirms the diagnosis. PSA is produced by the normal neoplastic ductal epithelium of the prostate and secreted into the lumen; its concentration in the blood is proportional to the total prostate mass. PSA levels will be elevated in all patients with prostatic cancer, and serum acid phosphatase levels will be elevated in two-thirds of men with metastatic prostatic cancer. Therapy aims to return the serum acid phosphatase level to normal; a subsequent rise points to recurrence. Magnetic resonance imaging, computed tomography scan, and excretory urography may also aid the diagnosis.
CLINICAL TIP: Elevated alkaline phosphatase levels and a positive bone scan point to bone metastasis.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Benign prostatic hyperplasia:
Diagnosis
(Handbook of Diseases)
Signs and symptoms and a rectal examination are usually sufficient for a diagnosis. Other test findings help to confirm it.
❑ Excretory urography may indicate urinary tract obstruction, hydronephrosis, calculi or tumors, and filling and emptying defects in the bladder.
❑ Elevated blood urea nitrogen and serum creatinine levels suggest impaired renal function.
❑ Urinalysis and urine culture show hematuria, pyuria and, when the bacterial count exceeds 100,000/µl, urinary tract infection.
With severe symptoms, a cystourethroscopy is definitive, but this test is performed only immediately before surgery to help determine the best procedure. It can show prostate enlargement, bladder wall changes, and a raised bladder.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Prostatitis:
Diagnosis
(Handbook of Diseases)
Although a urine culture can usually help identify the causative infectious organism and rectal examination findings may suggest prostatitis, firm diagnosis depends on a comparison of urine cultures of specimens obtained by triple-void urine specimens. This test requires three specimens:
❑ one collected when the patient starts voiding (voided bladder one [VB1])
❑ another specimen collected midstream (VB2)
❑ another specimen collected after the patient stops voiding and the physician massages the prostate to express prostate secretions.
A significant increase in colony count in the prostatic specimens confirms prostatitis.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
PROSTATIC MASS OR ENLARGEMENT:
Approach to the Diagnosis
(Differential Diagnosis in Primary Care)
The main consideration in diagnosing a prostatic mass is to rule out
carcinoma. It is therefore wise to draw blood for prostate-specific antigen
(PSA) before proceeding in anyone who is suspected of having prostate
cancer. If the mass is located in the posterior lobes, there is further
support for the diagnosis. Ultrasonography can be done for further
localization before proceeding with a biopsy. Obviously, if the PSA test is
positive, referral to a urologist is mandatory, although false-positives can
occur in this test. A large, boggy prostate suggests a prostatic abscess or
prostatitis. If there is no urethral discharge, one can elicit a discharge
by prostatic massage. However, this should not be done if the patient has
fever and significant tenderness of the prostate. It is better to proceed
with antibiotic therapy and reexamine the patient after the fever has
subsided. A smear and culture of the discharge is made. If upon examining
the discharge under high-power microscopy, four or more white blood cells
(WBCs) per high-power field are found, the diagnosis of prostatitis can be
made. If benign prostatic hypertrophy is suspected, cystoscopy and
retrograde pyelography can be done.
» READ BOOK EXCERPT ONLINE »
Source: Differential Diagnosis in Primary Care, 2007
Prostate cancer is the second leading cancer killer of men in the U.S. Among the treatment options for this disease are surgery, radiation therapy...
Bill Blair is a cancer researcher who found himself stricken with prostate cancer. True to his nature he has fought both the disease and side effects...
The PSA test remains a controversial screening tool for prostate cancer, but there is little doubt on its value for helping with treatment decisions....
There's an on-going debate within the medical community about the merits of routine screening for prostate cancer. Get the latest information and...
See full list of 23 related videos
» Next page: Signs of Prostate Cancer
Rate This Website
What do you think about the features of this website?
Take our user survey and have your say:
Website User Survey
Medical Tools & Articles:
Next articles:
Tools & Services:
Medical Articles:
Forums & Message Boards
- Ask or answer a question at the Boards:
