Is it Prostate Cancer?
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.
These may include:
- An ultrasound test where a probe is inserted into the rectum. Sound waves bounce off the prostate, and a computer uses the echoes to create a picture called a sonogram. The medical name for this test is transrectal ultrasonography.
- A series of X-rays of the organs of the urinary tract are ordered in an intravenous pyelogram.
- The cystoscopy is a procedure in which a doctor looks into the urethra and bladder through a thin, lighted tube.
A man who needs a biopsy may want to ask the doctor some of the following questions:
- How long will the procedure take? Will I be awake? Will it hurt?
- Are there any risks? What are the chances of infection or bleeding after the biopsy?
- How soon will I know the results?
- If I do have cancer, who will talk to me about treatment? When?
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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.
