| There are approximately 25,000 men newly | | | | CT OR MRI SCAN |
| diagnosed with prostate cancer every year in | | | | |
| the United Kingdom. For these men the risk of | | | | This is usually carried out in an x-ray |
| dying from their prostate cancer depends on a | | | | department and involves lying still on a thin |
| number of risk factors. For example if the | | | | couch which moves through either a big donut |
| cancer is confined to the prostate gland at | | | | (CT) or into a long tunnel (MRI). This is not |
| diagnosis the chance of surviving to 5 years | | | | painful in any way. The pictures gained from |
| is 70%. If the cancer has already spread e.g. | | | | this test helps the doctors to see whether |
| to the bones then only 20% of men will | | | | the prostate cancer is still within the |
| survive to five years. Of all the men who | | | | prostate gland or whether it had started to |
| currently have prostate cancer in the UK | | | | invade out of the gland into other |
| approximately 10,000 will die of the disease | | | | surrounding structures. This tells the doctor |
| each year. The prostate cancer survival rate | | | | what "stage" the prostate cancer is. |
| is much higher in the developed world - | | | | |
| unsurprisingly. | | | | BONE SCAN |
| | | | |
| When a man is first diagnosed with prostate | | | | This requires you to have an injection and |
| cancer then the doctor who has found the | | | | then to lie on a special table where a camera |
| cancer (most often a "urologist" - a surgeon | | | | scans the whole body. It shows up whether any |
| who specialises in looking after problems to | | | | of the bones in the body have been affected |
| do with the kidneys, prostate and bladder) | | | | by the prostate cancer i.e. whether the |
| will arrange a series of tests to help assess | | | | prostate cancer has spread to the bones. |
| the risk for that individual patient. The | | | | |
| results of these tests will in turn help the | | | | PROSTATE CANCER STAGE AND SURVIVAL |
| doctor and patient to decide the best | | | | |
| treatment for that patient. | | | | The stage of prostate cancer describes how |
| | | | far the cancer has grown and spread. It is |
| PROSTATE CANCER TESTS TO HELP PREDICT | | | | assessed by a mixture of DRE and CT/MRI |
| SURVIVAL | | | | scans. |
| | | | |
| 1. Prostate Specific Antigen or PSA | | | | T1 STAGE |
| | | | |
| 2. Digital Rectal Examination or DRE | | | | This is very early prostate cancer which can |
| | | | only be seen under a microscope. At this |
| 3. Trans-rectal Ultrasound and Biopsy | | | | stage the cancer would not cause any |
| | | | symptoms. Men with this stage are at low risk |
| 4. CT or MRI Scan | | | | from their disease may not need any treatment |
| | | | but surveillance. The original cause of a |
| 5. Bone Scan | | | | prostate cancer problem can be difficult to |
| | | | diagnose. |
| PSA | | | | |
| | | | T2 STAGE |
| This is a protein made by the prostate gland | | | | |
| which can be measured on a sample of your | | | | This is early prostate cancer but is now big |
| blood i.e. a blood test. The PSA level can be | | | | enough to be felt by a doctor on DRE. This |
| raised by non cancerous problems with the | | | | may still not have caused any symptoms. This |
| prostate gland i.e. not all men who have a | | | | is most often cured if treatment is |
| raised PSA have prostate cancer. Also some | | | | undertaken at this stage and about 70% of men |
| men who have prostate cancer will not have a | | | | are still alive after 5 years i.e. average |
| raised PSA. However PSA does tend to increase | | | | length of survival from diagnosis is well |
| as prostate cancers grow, invade and spread | | | | over 5 years. |
| so PSA can be used to monitor how a prostate | | | | |
| cancer is progressing or how it is responding | | | | T3 STAGE |
| to treatments. | | | | |
| | | | This is locally advanced prostate cancer |
| DRE | | | | which has started to extend and invade |
| | | | outside of the prostate gland. This stage |
| This is where a doctor feels the prostate | | | | would often cause bladder symptoms in men. By |
| gland through the back passage. It tells the | | | | this stage in the disease the chance of cure |
| doctor how big the prostate gland is, whether | | | | with treatments is reduced however survival |
| the cancer is able to be felt easily and | | | | is often around five years. |
| whether it has invaded the area near by. | | | | |
| | | | T4 STAGE |
| TRAN-RECTAL ULTRASOUND AND BIOPSY | | | | |
| | | | This is more advanced prostate cancer which |
| For this test you need to lie on your side | | | | invades the structures around the gland. At |
| with your knees brought up into the chest | | | | this stage there are often already |
| (same position as for a DRE). An ultrasound | | | | secondaries e.g. bone metastases. If the |
| probe is then inserted into the back passage. | | | | disease has spread it is usually incurable |
| This enables the doctor to see on a screen | | | | but may be controlled for some time. The |
| the outline of the prostate gland. There is | | | | average survival is between 1 and 3 years. |
| no radiation involved. The image on the | | | | |
| screen then allows the doctor to insert a | | | | PREDICTING SURVIVAL IN PROSTATE CANCER |
| needle safely into the prostate gland to take | | | | |
| some samples of the prostate tissue. Usually | | | | Doctors use a combination of risk factors to |
| several samples are taken from each area of | | | | predict the behaviour of prostate cancer but |
| the prostate gland. These samples are then | | | | cancers do not always act as expected. The |
| sent to a laboratory to be looked at under a | | | | factors they consider include the cancer |
| microscope. This allows confirmation that | | | | stage (see above), the age of the patient, |
| there is prostate cancer present and tells us | | | | the PSA level and how quickly it is rising, |
| how aggressive the cancer looks. Sometimes a | | | | and the Gleason Score. The Gleason score is a |
| local anaesthetic is used to help make the | | | | marker of how aggressive the cancer looks |
| procedure more comfortable. | | | | under the microscope and how much of the |
| | | | gland is affected by cancer. |