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Detecting Prostate Cancer
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Your doctor usually will do a digital rectal exam (DRE) to feel for bumps or hard spots on the prostate. A blood test will measure prostate-specific antigen (PSA), a protein produced by prostate cells. Doctors now know that no PSA level guarantees the absence of prostate cancer.
In other words, no PSA is truly normal. For that reason, the decision to recommend a biopsy is based on several factors.
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A biopsy is performed by inserting a needle through the rectum wall or the skin between the rectum and scrotum. A local anesthetic can greatly reduce the discomfort. Multiple small tissue samples are removed and examined under a microscope. The entire procedure takes less than 15 minutes. Possible side effects include bleeding and infection.
If cancer is detected, some men may need additional tests to see if the cancer has spread beyond the prostate. These can include ultrasound, a CT scan, an MRI scan and a bone scan.
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Determining the Tumor’s Aggressiveness
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Doctors can determine the aggressiveness of the tumor based on the appearance of the cancer cells under a microscope. Each tumor is assigned a number called the Gleason score. It is based on the appearance of the most common and second most common type of cells seen. A number from one to 5 is assigned to each cell type and the two are added together. Higher Gleason scores usually are more aggressive.
The least aggressive cancer has a Gleason score of 1+1=2 and the most aggressive tumor has a Gleason score of 5+5=10. Gleason scores are one of the factors that influence the type of treatment a man should have.
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