Prostate cancer is one of the most common cancers among men. Thankfully a screening plan can be started at age 50 for men at average risk to detect prostate cancer at an earlier stage.
The signs of prostate cancer are not always obvious, that's why the American Cancer Society suggests you start a screening program and stick to routine screenings.
Prostate Cancer Screening
For men considered at a higher risk for developing prostate cancer, screening may be recommended earlier at the age of 40 or 45. A history of cancer in your family, certain health conditions, and several other risk factors may require screenings to begin before the age of 50.
Watch the video for a guide to prostate cancer screening.
During an office visit, your doctor will ask about your personal and family medical history. You’ll have a physical exam. You may also have one or both of the following tests:
- Digital rectal exam: Your doctor inserts a lubricated, gloved finger into the rectum and feels your prostate through the rectal wall. Your prostate is checked for hard or lumpy areas.
- Blood test for prostate-specific antigen (PSA): A lab checks the level of PSA in your blood sample. The prostate makes PSA. A high PSA level is commonly caused by BPH or prostatitis (inflammation of the prostate). Prostate cancer may also cause a high PSA level.
How is Prostate Cancer Detected?
The digital rectal exam and PSA test can detect a problem in the prostate. However, they can’t show whether the problem is cancer or a less serious condition. If you have abnormal test results, your doctor may suggest other tests to confirm a diagnosis. Your doctor may order other procedures:
- Transrectal ultrasound: The doctor inserts a probe into the rectum to check your prostate for abnormal areas. The probe sends out sound waves that people cannot hear (ultrasound). The waves bounce off the prostate. A computer uses the echoes to create a picture called a sonogram.
- Transrectal biopsy: A biopsy is the removal of tissue to look for cancer cells. It’s the only sure way to diagnose prostate cancer. The doctor inserts needles through the rectum into the prostate. The doctor removes small tissue samples (called cores) from many areas of the prostate. Transrectal ultrasound is usually used to guide the insertion of the needles. A pathologist checks the tissue samples for cancer cells.
What to Expect If Prostate Cancer Is Found
A urologist is often the doctor who orders the ultrasound and performs the biopsy to determine if prostate cancer is present. If prostate cancer is detected there are choices to make based on the Gleason score and how much the cancer has grown. The extent of cancer is referred to as the stage of cancer.
The pathologist studies tissue samples from the prostate under a microscope to report the grade of the tumor. The grade tells how much the tumor tissue differs from normal prostate tissue. It suggests how fast the tumor is likely to grow.
Tumors with higher grades tend to grow faster than those with lower grades. They are also more likely to spread. Prostate cancer doctors use tumor grade along with your age and other factors to suggest treatment options.
About the Gleason Score and Grades of Prostate Cancer
One system of grading is with the Gleason score. Gleason scores range from 2 to 10. To come up with the Gleason score, the pathologist uses a microscope to look at the patterns of cells in the prostate tissue. The most common pattern is given a grade of 1 (most like normal cells) to 5 (most abnormal). If there is a second most common pattern, the pathologist gives it a grade of 1 to 5, and adds the two most common grades together to make the Gleason score. If only one pattern is seen, the pathologist counts it twice. For example, 5 + 5 = 10. A high Gleason score (such as 10) means a high-grade prostate tumor. High-grade tumors are more likely than low-grade tumors to grow quickly and spread.
Another system of grading prostate cancer uses grades 1 through 4 (G1 to G4). G4 is more likely than G1, G2, or G3 to grow quickly and spread. Read more about prostate cancer staging.
What Happens After a Prostate Cancer Diagnosis?
Typically, the doctor who orders the ultrasound and performs the biopsy to diagnose prostate cancer is a urologist. The next step is to consider treatment options based on your Gleason score and the prostate cancer stage.
The prostate cancer doctors at Affiliated Oncologists work with you to create a personalized prostate cancer treatment plan based on your specific condition. If you have been newly diagnosed with prostate cancer, find an oncologist at one of our cancer centers located throughout the suburbs of South Chicago.