Diagnostic Tests for Prostate Cancer
Although an increasing number of men are now diagnosed with asymptomatic prostate cancer, many men with this form of cancer have either locally advanced cancer or distant metastasis at the time of diagnosis. Because there are no current ways to prevent the development of prostate cancer it is important that early detection be used as a major emphasis to control this disease. While there are tests that may give an indication that prostate cancer is present only a biopsy can give a definitive diagnosis.
• Digital Rectal Exam (DRE) – The prostate gland is nodular and fixed if cancer is present. While not the most favorite of exams for men it is important to have these done on a regular basis, particularly after the age of 40.
• Prostate-specific antigens (PSA) – Levels of PSA are used to diagnose and stage prostate cancer, and to monitor response to treatment. Normal levels of PSA are 10 ng/mL. Men with BPH will also have elevated PSA levels but two-thirds of those with a PSA greater than 10 ng/mL will have prostate cancer.
• Transrectal ultrasonography – This test is used when the digital rectal exam is abnormal or if the PSA is elevated.
• Prostate biopsy – This test must be performed and interpreted before the diagnosis of prostate cancer can be established. Either a needle biopsy or a TRUS-guided biopsy is performed.
• Grade and stage – This helps determine prognosis and guide treatment decisions. Grade, which refers to cancer cell differentiation, is determined by a pathologist. Prostate cancer can be staged with a variety of tests.
• Bone scan, MRI, or CT scans – These tests may be performed to determine the presence of tumor metastasis.
Several studies have shown a positive correlation between increased awareness of and participation in prostate cancer screening procedures. All men should be aware of the limitations and benefits of testing for early detection and treatment so they can make an informed decision about their own health care needs.
The American Cancer Society recommends that the PSA and DRE should be given every year starting at the age of 50. Men at a higher risk, such as men with a first degree relative diagnosed at a young age or men of African descent, should begin testing at the age of 45. Men at an even higher risk, such as multiple relatives with positive diagnosis's, should begin testing at the age of 40.
Questions and Answers
Generally physicians agree that elevated PSA levels result in a need to notify the patient and to recommend more testing to rule out prostate cancer. If the patient does have prostate cancer not informing the patient and permitting time to go by absent diagnostic testing risks letting the cancer to spread. In the event that this occurs the patient might be able to pursue a case against the doctor.
Typically physicians concur that raised PSA levels trigger a need to notify the patient and to order more testing to establish if it is due to prostate cancer. In case the patient does have prostate cancer not telling the patient and letting time go by absent diagnostic testing risks allowing the cancer to spread. In the event that this takes place the patient might be able to pursue a medical malpractice claim against the doctor.
Generally physicians acknowledge that raised PSA levels create a need to inform the patient and to order additional testing to determine whether it is due to prostate cancer. In case the patient has prostate cancer not informing the patient and letting time go by absent diagnostic testing risks allowing the cancer to spread. When this takes place the patient might have a medical malpractice claim against the physician.
Diagnostic tests for effective cancer screening are obviously needed more than ever. As cancer becomes more treatable, diagnostics are finding multiple expanded roles, including pharmacodiagnostics for matching the targeted treatment to the patient and ongoing disease monitoring as treatable cancer enters the realm of the chronic disease.
British scientists have developed "the first reliable test of whether men are at high risk of prostate cancer", reported the Daily Mail. It said the test has so far proven to be twice as precise as the existing PSA test, and is of urine rather than blood, which would make it cheaper to perform.
Cancer translational research brings together scientists' and clinicians' suggestions to develop solutions to biomedical complications. This kind of applied research strives to offer strategies to questions surrounding the etiology, pathology, diagnosis, prevention and treating cancer.
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