HOW TO DIAGNOSE PROSTATE CANCER

Earlier the diagnosis, higher the chances of curing any cancer,especially so ,prostate cancer.Any man can develop prostate cancer.There are 2 standard SCREENING tests which are the first steps to diagnose a prostate cancer .A screening test is one which is done when a person has no symptoms.The 2 screening tests are :1.PSA (prostate specific antigen)-- This is a simple blood test .If the values are above normal, a person has to undergo further investigations to rule out a malignancy.
2.DIGITAL RECTAL EXAMINATION (DRE)-- This is an outpatient procedure which is done with a finger inserted into the rectum to assess the prostate gland.
3.BIOPSY --- If the PSA and DRE are abnormal, then the patient is advised to undergo a biopsy.This procedure can be done as an outpatient with the help of a transrectal ultrasound probe.It is usually painless, and takes about 10 minutes.Sometimes, there may be a liitle bleeding after the procedure which usually subsides in a few hours. Multiple bits of the prostate tissue from different quadrants are removed from the prostate gland and sent for histopathology examination.This test will confirm whether a malignancy is present or not. The pathologist will give a report on a.whether a malignancy is present,
b.if present, then which quadrants are positive,
c. what type of maligancy is present(adenocarcinoma is the commonest)
d.Gleason's score.The gleasons score usually determines the aggressiveness of the cancer, a lower score meaning less aggressive and a higher score meaning more aggressive tumor.
The treatment decisions are taken after all this information is ready.
4.DIAGNOSTIC IMAGING: Once a cancer is confirmed, further tests like transrectal ultrasound,CT /MRI /PET CT scans , NUCLEAR BONE SCANS may be ordered to know the extent of the disease and hence stage it.

What is prostate gland?

The prostate gland is an organ of the male reproductive system. It is shaped like a walnut and is found at the base of the bladder. There is a thin tube(urethra) running through the prostate gland that allows urine and semen to pass out of the penis. Alkaline fluid produced by this gland helps to nourish sperm and leaves the urethra as ejaculate. Another function of the prostate gland is to help control urination. However men can survive without a prostate gland.

The prostate undergoes two main growth spurts. The first is fuelled by the sex hormones made by the testicles during puberty. This prompts the gland to reach an average weight of 20g. The second growth spurt happens sometime in the fourth decade of life. 

The three most common forms of prostate disease are

1. non-cancerous enlargement, also known as benign prostatic hypertrophy(BPH)

2. inflammation(Prostatitis) 

3. cancer. 

A man may experience one problem or a combination of two or more problems.

Diagram showing the position of the prostate gland

SYMPTOMS OF PROSTATE CANCER

Symptoms of prostate cancer can vary from patient to patient.Symptoms can mimic those of benign prostatic hypertrophy or prostatism.

• Weak urinary stream
• Inability to urinate
• Blood in the urine
• Interruption of urinary stream (stopping and starting)
• Frequent urination (especially at night)
• Pain or burning during urination

Prostate cancer is a disease in which cancer develops in the prostate, a gland in the male reproductive system. It occurs when cells of the prostate mutate and begin to multiply out of control. These cells may spread (metastasize) from the prostate to other parts of the body, especially the bones and lymph nodes. Prostate cancer may cause pain, difficulty in urinating, erectile dysfunction and other symptoms.This cancer can occur only in men, as the prostate gland is found only in the male reproductive tract. It is one of the most common types of cancer in men.

PROSTATE CANCER incidence

The term 'prevalence' of Prostate Cancer usually refers to the estimated population of people who are managing Prostate Cancer at any given time. The term 'incidence' of Prostate Cancer refers to the annual diagnosis rate, or the number of new cases of Prostate Cancer diagnosed each year. Hence, these two statistics types can differ: a short-lived disease like flu can have high annual incidence but low prevalence, but a life-long disease like diabetes has a low annual incidence but high prevalence.

Prostate cancer incidence statistics for men in various countries:
112.3 men per 100,000 population with prostate cancer in the US 1993-97 (Surveillance and Risk Assessment Division, CCDP, Health Canada)
80.2 men per 100,000 population with prostate cancer in Canada 1993-97 (Surveillance and Risk Assessment Division, CCDP, Health Canada)
63 men per 100,000 population with prostate cancer in Sweden 1993-97 (Surveillance and Risk Assessment Division, CCDP, Health Canada)
42.2 men per 100,000 population with prostate cancer in Colombia 1993-97 (Surveillance and Risk Assessment Division, CCDP, Health Canada)
39.6 men per 100,000 population with prostate cancer in the UK 1993-97 (Surveillance and Risk Assessment Division, CCDP, Health Canada)
32 men per 100,000 population with prostate cancer in the Czech Republic 1993-97 (Surveillance and Risk Assessment Division, CCDP, Health Canada)
29.9 men per 100,000 population with prostate cancer in Denmark 1993-97 (Surveillance and Risk Assessment Division, CCDP, Health Canada)
22.2 men per 100,000 population with prostate cancer in Poland 1993-97 (Surveillance and Risk Assessment Division, CCDP, Health Canada)
13.9 men per 100,000 population with prostate cancer in Singapore 1993-97 (Surveillance and Risk Assessment Division, CCDP, Health Canada)
9.0 men per 100,000 population with prostate cancer in Japan 1993-97 (Surveillance and Risk Assessment Division, CCDP, Health Canada)
8.6 men per 100,000 population with prostate cancer in China 1993-97 (Surveillance and Risk Assessment Division, CCDP, Health Canada)
7.4 men per 100,000 population with prostate cancer in India 1993-97 (Surveillance and Risk Assessment Division, CCDP, Health Canada)