Reading Urology : Prostate cancer 2

Prostate cancer is described as ‘early’ or ‘late’. It starts with changes in the cells in the prostate, which form a lump that may be felt in a physical examination. Surgeons describe how far the cancer has spread according to T (tumour)-stages.

Unfortunately it is only when the cancer has advanced that most men will get symptoms which make them visit their doctor. This means that about half the men diagnosed will already be a late or advanced stage of prostate cancer. However, it may still be possible to slow down the growth of the tumour; see part 5.

Tests for prostate cancer

Common tests for prostate cancer are

PSA blood test
DRE, a digital rectal examination.

It then has to be confirmed by examining a biopsy of the prostate tissue under a microscope.

PSA (Prostate specific antigen) blood test

PSA is made by the prostate and may leak into your bloodstream if you have prostate cancer. Normally a man without cancer will have a PSA level of less than 4 micrograms per litre. However, a raised PSA level may be caused by other factors and a high PSA level does not necessarily mean you have cancer. Nor does a lower level mean that cancer is absent.

DRE (Digital rectal examination)

You will be asked to lie on your side with your knees drawn up towards your chin. The consultant will then put a gloved finger into your rectum to feel the prostate through the rectum wall.

TRUS (Transrectal ultrasound) and biopsy

After monitoring your PSA, your consultant may suggest that you need a biopsy. This means that a sample of tissue from the prostate is taken for analysis.

You will be asked to lie on your side with your knees drawn up towards your chin. A probe is inserted into the rectum and an image of your prostate can then be seen on a screen. A needle will then be used to take samples which are sent to the laboratory for examination under the microscope. This procedure is performed under a local anaesthetic during our normal clinic times.

Scans

A bone scan shows if the cancer has spread into your bones. A tiny, harmless amount of radioactive material is injected into your veins and is absorbed by any abnormal bone tissue. Any spread of cancer to the bones will then show later as a dark mark on the scan.

You may also have a CT scan or MRI scan. These help to distinguish between early and late prostate cancer.

Treatments for early prostate cancer

There are three choices of treatment for early cancers

Watch and wait
Radical prostatectomy
Radical radiotherapy

Although each may be equally effective they have different effects on your quality of life so you have a part to play in making an informed choice. Our consultants will take the important factor of age into consideration when deciding which treatment they recommend. Generally it is agreed that the younger patient (under 70) should have one of the radical treatments rather than watch and wait because they are likely to live long enough for any cancer to grow and cause more harm.

Watch & wait approach

This involves regular checkups to monitor your prostate cancer and you will generally be referred back to your GP for this. If your PSA rises or there is any change in your condition, your GP will refer you back to us for further consultation and treatment.

Please go on to Prostate Cancer 3 for more information
Go back to Prosate Cancer 1

See also Prostate Cancer Diet Guidelines

Relevant links
Cancer BACUP      0808 800 1234
MacMillan CancerLine     0808 808 2020
Cancer Research UK      0800 226 237
Prostate Cancer Support Organisation      0845 650 2555
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