What are the Tests for Prostate Cancer? Symptoms & Causes of Prostate Cancer

Most of you must have heard of one of the most common cancers that occurs in men – prostate cancer. It is a cancer that occurs in a man’s prostate, which is a small walnut-shaped gland that produces the seminal fluid as well as nourishes and transports sperm.

Prostate cancer usually grows slowly and in the initial stage remains confined to the prostate gland, where it does not cause serious harm. While some types of prostate cancer develop slowly and may need little or no treatment, other types are aggressive and can spread rapidly. When the prostate cancer is detected in the early stages when it is still confined to the prostate gland, it has a better chance of cure.

Symptoms of Prostate Cancer

One of the features of Prostate cancer is that it may show no signs or symptoms in its early stages. But, in the more advanced stages, it may cause signs and symptoms such as:

• Trouble urinating
• Decreased force in the stream of urine
• Blood in the semen
• Discomfort in the pelvic area
• Bone pain

Causes of Prostate Cancer

It is not very clear what causes prostate cancer. But, we do know that prostate cancer begins when some cells in the prostate become abnormal. Mutations in the DNA of the abnormal cells cause the cells to grow and divide more rapidly than normal cells.

How to Check for Prostate Cancer

There are differing schools of thought on testing healthy men with no symptoms for prostate cancer. Many medical organizations do not agree on the issue of screening and doubt if it has benefits.
While some medical organizations recommend that men in their 50s should undergo tests for prostate cancer, there are other organizations who advise against the screening. Men, who have risk factors for prostate cancer, are also advised to undergo the test.
You should discuss about the benefits and risks of screening with your doctor, and can then decide whether prostate cancer screening is right for you.

• Digital Rectal Exam (DRE): During a Digital Rectal Exam, the doctor inserts a gloved, lubricated finger into your rectum to examine your prostate, which is located adjacent to the rectum. If the doctor finds any abnormalities in the texture, shape or size of the gland, you may need to undergo further tests.

• Prostate-Specific Antigen (PSA) test: A blood sample is drawn from a vein in your arm and analyzed for Prostate-specific Antigen – PSA. PSA is a substance that is naturally produced by your prostate gland. While it is normal for a small amount of PSA to be found in your bloodstream, a higher level may indicate infection, inflammation, enlargement or cancer.

PSA testing, along with the DRE, helps identify prostate cancers in the early stages. But studies have completely disagreed whether these tests can reduce the risk of death from prostate cancer.

New Generation Tests for Prostate Cancer

Men would be happy to hear that a new generation of tests for prostate cancer, which is more reliable than blood prostate specific antigen (PSA) tests, are now available to them. These tests also act as early detection tests for prostate cancer.

• Phi test: This is a blood-based test that is three times more specific in detecting prostate cancer than prostate-specific antigen (PSA). While PSA is, at present, the most widely used screening test for prostate cancer, PSA results can often indicate the possibility of prostate cancer, when cancer is not present. Higher phi values, on the other hand, are associated with increased probability of prostate cancer, and with more aggressive disease.

• STHLM3 test: This is a new procedure, called the STHLM3 test, which analyzes a simple blood sample from the patient for a combination of six protein markers (PSA, free PSA, intact PSA, hK2, MSMB, and MIC1) and 232 single nucleotide polymorphisms (SNPs), along with clinical data such as age, family history, and previous prostate biopsies.The results showed that the STHLM3 test reduced the number of biopsies considerably without compromising patient safety. In addition, the STHLM3 test found aggressive cancers in men with low PSA values that typically go undetected by current methodology of testing.

• Mi-Prostate Score (MiPS): Researchers at the University of Michigan Health System in the USA have developed a urine test – Mi-Prostate Score (MiPS) – which, is more accurate than the PSA test. The test looks for specific markers that could indicate cancer, including PCA3, a gene found in the prostate. But, the test, which is still only available in a few advanced countries, can also tell if a cancer is aggressive and likely to grow and spread quickly.

Diagnosing Prostate Cancer

If an abnormality is discovered in a DRE or PSA test, the doctor may recommend tests to determine whether you have prostate cancer, such as:

• Ultrasound: Your doctor may use Transrectal ultrasound to further evaluate your prostate. A small probe, about the size and shape of a cigar, is inserted into your rectum. The probe uses sound waves to create a picture of your prostate gland.
• Prostate Tissue sample: If initial test results suggest prostate cancer, your doctor may order a procedure to collect a sample of cells from your prostate, which is known as a prostate biopsy. Prostate biopsy is usually done using a thin needle that is inserted into the prostate to collect tissue. The tissue sample is analyzed in a lab to find out if cancer cells are present.

If the biopsy confirms the presence of cancer, the level of aggressiveness or the grade of the cancer cells is determined. A pathologist examines the sample to determine how much cancer cells differ from the healthy cells. A higher grade is an indication that the cancer is aggressive and is likely to spread quickly.

Determining the Extent of Prostate Cancer

Once a prostate cancer diagnosis has been confirmed, your doctor would determine the stage of the cancer. If your doctor suspects your cancer may have spread beyond your prostate, the following imaging tests may be recommended:

• Bone scan
• Ultrasound
• Computerized tomography – CT scan
• Magnetic resonance imaging (MRI)
• Positron emission tomography – PET scan

The doctor would determine the stage of cancer, which would help determine your treatment options.

The Various Prostate Cancer Stages are:

• Stage I: This stage shows very early cancer that is confined to a small area of the prostate.
• Stage II: Cancer at this stage may still be small but may be considered aggressive. The cancer in stage II may be larger and may have grown to involve both sides of the prostate gland.
• Stage III: The cancer has spread beyond the prostate to the seminal vesicles or other nearby tissues.
• Stage IV: The cancer has reached nearby organs, such as the bladder, or spread to lymph nodes, bones, lungs or other organs.