What we know based on current research is that there is a strong genetic component that causes prostate cancer. Most men will have prostate cancer at some point before they die but it is the progression and type of prostate cancer that affects mortality.
So.. how do they diagnose?
SIGNS or SYMPTOMS:
Generally there are NO signs that you have prostate cancer... sometimes you can have problems with urination, difficulty peeing, blood in your urine, or incontinence.. in advanced stages you may have fatigue or experience pain in your joints or bones
What they will check FIRST: a prostate exam includes a licensed provider placing their gloved finger into the anus and feeling for the prostate...
if there is concern, NEXT step: blood test
What the blood test looks for is an elevated Prostate Specific Antigen (PSA)
Normal levels:
ACTIVE SURVEILLANCE: re-check PSA levels every 3 months to monitor
** PSA enters the blood by leaking from the prostate, this can be due to trauma to the prostate (like from riding a bike) or from infection and is not always a sign of cancer..
If significant concern they will complete a biopsy: use a needle to get a tissue sample from prostate
Pathology of a Biopsy:
I. A Gleason Score: based on 2 tissue samples taken from the prostate
Do the cancerous cells taken from (biopsied from) the prostate all look like one another or do they look very different from one another?
Score 2-4: look like all the other cells i.e.: well differentiated
Score 5-7: look like other cells but some that do not i.e.: moderately differentiated
Score 8-10: do not look the same at all i.e.: poorly differentiated
The LOWER the score the LOWER the risk of progressive cancer.
II. Classification of the Cancer: based on how it has spread within or outside of the prostate
T1c: no symptoms of cancer, found by chance looking for something else
T2a, T2b: cancer cells limited to half of one lobe or one lobe of the prostate
T2c: cancer cells in both lobes
T3a, T3b: cancer cells spread through one wall or through both walls of the prostate
T3c: cancer cells spread through the walls and to the seminal vesicles (another reproductive part)
T4: cancer cells have spread and invaded other structures
III. PSA levels: prostate specific antigen in the blood.
Normal levels:
THE HIGHER THE RISK.. the MORE ADVANCED and progressive disease will be.
Although we can identify the risk for quick progression of the disease, we do not know exactly how long it will take. Maintaining a healthy diet, getting exercise and maintaining a healthy sleep cycle to combat fatigue will inevitably help live a longer more fulfilling life with prostate cancer.
So.. how do they diagnose?
SIGNS or SYMPTOMS:
Generally there are NO signs that you have prostate cancer... sometimes you can have problems with urination, difficulty peeing, blood in your urine, or incontinence.. in advanced stages you may have fatigue or experience pain in your joints or bones
What they will check FIRST: a prostate exam includes a licensed provider placing their gloved finger into the anus and feeling for the prostate...
FURTHER EXPLANATION:
if there is concern, NEXT step: blood test
What the blood test looks for is an elevated Prostate Specific Antigen (PSA)
Normal levels:
- 40 to 49 years — 0 to 2.5 ng/ml
●50 to 59 years — 0 to 3.5 ng/mL
●60 to 69 years — 0 to 4.5 ng/mL
●70 to 79 years — 0 to 6.5 ng/mL
Depending on the level and your risk factors... you may be placed on a WATCHACTIVE SURVEILLANCE: re-check PSA levels every 3 months to monitor
** PSA enters the blood by leaking from the prostate, this can be due to trauma to the prostate (like from riding a bike) or from infection and is not always a sign of cancer..
If significant concern they will complete a biopsy: use a needle to get a tissue sample from prostate
Pathology of a Biopsy:
I. A Gleason Score: based on 2 tissue samples taken from the prostate
Do the cancerous cells taken from (biopsied from) the prostate all look like one another or do they look very different from one another?
Score 2-4: look like all the other cells i.e.: well differentiated
Score 5-7: look like other cells but some that do not i.e.: moderately differentiated
Score 8-10: do not look the same at all i.e.: poorly differentiated
The LOWER the score the LOWER the risk of progressive cancer.
II. Classification of the Cancer: based on how it has spread within or outside of the prostate
T1c: no symptoms of cancer, found by chance looking for something else
T2a, T2b: cancer cells limited to half of one lobe or one lobe of the prostate
T2c: cancer cells in both lobes
T3a, T3b: cancer cells spread through one wall or through both walls of the prostate
T3c: cancer cells spread through the walls and to the seminal vesicles (another reproductive part)
T4: cancer cells have spread and invaded other structures
III. PSA levels: prostate specific antigen in the blood.
Normal levels:
- 40 to 49 years — 0 to 2.5 ng/mL
●50 to 59 years — 0 to 3.5 ng/mL
●60 to 69 years — 0 to 4.5 ng/mL
●70 to 79 years — 0 to 6.5 ng/mL
RISK ANALYSIS CHART:
What happens when it is detected, how do we know how progressive it will be?
Low
|
Intermediate
|
High
|
Very High
|
|
Grade
|
T1c, T2a
|
T2b-T2c
|
T3a
|
T3b, T4
|
Gleason Score
|
≤ 6
|
7
|
8-10
|
|
PSA level
|
≤ 10
|
10-20
|
> 20
|
THE HIGHER THE RISK.. the MORE ADVANCED and progressive disease will be.
Although we can identify the risk for quick progression of the disease, we do not know exactly how long it will take. Maintaining a healthy diet, getting exercise and maintaining a healthy sleep cycle to combat fatigue will inevitably help live a longer more fulfilling life with prostate cancer.
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