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Prostate Cancer - Diagnosis
An accurate diagnosis is very important to distinguish between
prostate cancer and other prostate problems. The basic tests
that your General Practitioner can do are the digital rectal
exam (DRE) and a blood test to detect PSA levels (Prostate
Specific Antigen) - a protein produced by the prostate. Rising
PSA may indicate a prostate abnormality. If the DRE or PSA tests
are abnormal, further studies may be conducted such as
a diagnostic ultrasound procedure called TRUS (Trans Rectal Ultra
Sound), biopsy, CT scan, MRI scan or Bone Scan.
Traditional biopsies may miss prostate cancer. Prostate Mapping offers greater precision in diagnosis. Prostate Mapping precisely locates high and low risk cancer. For more information about this form of diagnosis please see www.prostatemapping.com
The benefits of prostate cancer treatment depend on how large
the cancer already is and how far it may have spread. This is called
its ‘stage.’ It
is important for your doctor to determine the stage of your prostate
cancer because only by knowing how the cancer is growing and exactly
where it is located in the body can you and your healthcare professional
choose the best treatment for you.
Treatment of ‘early stage’ or ‘organ confined’ prostate cancer may be curative. Later stages of cancer, which have spread outside the prostate, may not be amenable to cure, however treatment can extend life and help relieve symptoms.
Stages:
- Stage 1: the cancer is very small and completely inside the prostate gland which feels normal when a rectal examination is done
- Stage 2: the cancer is still inside the prostate gland, but is larger and a lump or hard area can be felt when a rectal examination is done
- Stage 3: the cancer has broken through the covering of the prostate and may have grown into the neck of the bladder or the seminal vesicle
- Stage 4: the cancer has spread to another part of the body
For their records, doctors use a slightly more complicated staging system called the TNM system. This is used all over the world. It separately assesses the tumour (T), lymph nodes (N) and secondary cancer or metastases (M).
T (tumour) staging:
- T1 The tumour is too small to be seen on scans or felt during examination of the prostate. (It has been discovered by needle biopsy.
- T2 The tumour is completely inside the prostate gland
- T3 The tumour has broken through the capsule (covering) of the prostate gland
- T4 The tumour has spread into other body organs (secondary prostate cancer) nearby such as the rectum (back passage) or bladder
Lymph nodes are described as being 'positive' if they contain cancer cells. If a lymph node has cancer cells inside it, it is usually bigger than normal. The more it is affected by the cancer, the bigger it will be.
N (lymph node) staging:
- N0 No cancer cells found in any lymph nodes
- N1 One positive lymph node smaller than 2cm in greatest dimension
- N2 One positive lymph node that is between 2 and 5cm or multiple positive lymph nodes less than 5cm
- N3 Any positive lymph node that is bigger than 5 cm
M (metastases cancer spread) staging:
- M0 No distant metastasis
- M1 Distant metastasis
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