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