Prostate Cancer Basics

Prostate Cancer Diagnosis and Prevention

What can be done to prevent the disease?

As yet, prostate cancer cannot be completely prevented. Prostate screening with exams and blood tests helps with early diagnosis. The American Cancer Society, also called ACS, recommends that a digital rectal exam be offered every year to men 50 years of age or older who have a life expectancy of at least 10 years. A digital rectal exam involves a healthcare provider inserting his or her finger into a man's rectum to check if the patient's prostate is enlarged.

The ACS also recommends that a prostate-specific antigen test, also called a PSA blood test, be offered every year to men 50 years of age or older who have a life expectancy of at least 10 years. ACS recommends that screening start at the age of 45 years for African American men or men with a family history of prostate cancer.

Good dietary choices may also help prevent prostate cancer. The diet should be low in fat. Fruits, vegetables, and fatty fish help lower a man's risk for prostate cancer.

How is the disease diagnosed?

Diagnosis of prostate cancer begins with a medical history and physical exam. The healthcare provider will do a digital rectal exam. This involves inserting a gloved finger into the man's rectum to feel the prostate.

The PSA test, and a more refined version of it, may help in diagnosing prostate cancer. High levels of PSA suggest, but cannot prove, that a man has prostate cancer. However, very high levels of PSA can diagnose the disease. Normal ranges for PSA increase with age and are different according to race.

If prostate cancer is suspected, a biopsy may be done. During the biopsy, a needle is inserted into the prostate gland to obtain a small sample of tissue. The healthcare provider may order a transrectal ultrasound. This test uses sound waves to examine the inside of the gland. It can be used to guide the healthcare provider during a biopsy. If several areas of the prostate are in question, a number of biopsies may be done. The tissue is sent to a lab where it will be checked for cancer.

Prostate cancer is graded and staged for aggressiveness based on how far it has spread throughout the body.

  • Stages A and B are cancers confined to the prostate gland.
  • Stage C cancer has spread to other tissues near the prostate gland.
  • Stage D cancer has spread to lymph nodes or sites in the body a distance away from the prostate.

CT scans and bone scans help in staging. Sometimes staging only becomes clear at the time of surgery.

What are the long-term effects of the disease?

Long-term effects of prostate cancer depend on its stage and the type of treatment used. Some men who have slow-growing cancer can be monitored without treatment. Others live for a long time with prostate cancer that has spread to other sites in the body. Cancer that has spread is not curable in most cases. Unless other illnesses occur first, cancer that has spread usually causes death.

What are the risks to others?

Prostate cancer is not contagious and poses no risk to others. Prostate cancer does run in families. Brothers or sons of men who develop cancer should be aware of their family history. They should be screened for the disease as they grow older, as recommended by the ACS.

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