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