Diagnostic equipment and surgical procedures may help detect and diagnose
prostate cancer:
Prostate Specific Antigen (PSA) Test - a blood test which measures
PSA levels [
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Digital Rectal Exam (DRE) - a physician inserts a gloved finger in
the anus and feels the prostate for abnormalities
Transrectal Ultrasound - a probe is inserted into the rectum to
measure prostate volume and scan for tumor masses
Transrectal Ultrasound Guided Biopsy – a probe is inserted into the
rectum where eight to 12 small samples of prostate tissue may be taken
for biopsy, which is a microscopic evaluation of potential cancer cells
Grading the prostate cancer
If cancerous cells are found, they are rated from one to five using the
Gleason system. The Gleason system assigns the cells a grade based on how
the patterns, sizes and shapes of the cells are different from healthy
prostate cells.
If most of the cancerous tissue looks like normal prostate tissue, a
lower grade of one is assigned.
If the cancerous cells lack the features of a normal prostate cell
and demonstrate the highest prostate cancer cell type, a grade of five
is assigned.
Grades two, three and four have features between those described
above.
It is possible for different areas of the prostate to have different
Gleason grades, so samples from multiple areas of the prostate are taken and
graded using the Gleason system. Those two numbers are added together to
determine the overall Gleason Score, between two and ten. The lower
the number, the more the cancerous cells look like normal prostate cells.
The higher the number, the less these cells look like normal cells.
The Gleason Score is used to indicate the prostate cancer's
aggressiveness which helps determine the appropriate treatment.
Staging
Once prostate cancer is confirmed it is vitally important for our
physicians to determine whether or not the cancer has spread. Treatment
decisions hinge on the findings of the staging process. The stages refer to
the extent of the disease and similar stages have a similar outlook and thus
are treated in a similar way. Staging procedures used at Aurora Health Care
include:
Radionuclide bone scan -- This study determines
whether or not the cancer has spread to the bones. A small amount of
radioactive material is injected into the blood stream. If diseased bone
tissue exists, the radioactive material will show up in these areas,
which are then detected with a special camera. The amount of radioactive
material used is very small and causes no harmful side effects to the
patient. [
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Spiral computed tomography -- Spiral computed
tomography is an advanced type of CAT scan which yields more precise
details and images by creating three-dimensional images. Spiral CT's
show bone, soft tissue and blood vessels and pinpoint the cancer's
location.
Magnetic resonance imaging (MRI) -- A MRI uses
strong magnetic fields instead of x-rays to produce an image of the
body. MRI's produce a very clear picture of the prostate gland and can
show whether or not the cancer has spread. [
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Lymph node biopsy -- Physicians may take a sample
of lymph node tissue to determine if the cancer has spread further into
the pelvic area. The tissue sample may be obtained surgically, by using
a needle, or laparoscopically where a small camera is inserted through
an abdominal incision and guided to the lymph nodes around the prostate.
A small amount of tissue is removed and sent to the lab for analysis. [
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American Joint Committee on Cancer TNM system --
The American Joint Committee on Cancer (AJCC) uses a staging system (the
TNM) to describe the stages of cancer. The “T” stands for “tumor” and
its size, as well as how far it has spread is determined. The “N” stands
for “nodes”. It is determined whether or not the cancer has spread
to the lymph nodes, which typically help fight infections. The “M”
stands for metastasis, which determines if the cancer has spread to
distant organs.
Prostate cancer: Diagnostics & staging 