Posts Tagged ‘digital rectal exam
Prostate Cancer Symptoms – Benefits Of Early Diagnosis
Cancer of the prostate is typically a slow progressing cancer and symptoms often do not arise for many years. If the cancer is caught at an early stage, there might be no noticeable symptoms. Some men, however, will experience symptoms that could indicate the presence of prostate cancer. These might include:
* A need for frequent urination, particularly at night
* Difficulty starting urination
* Weak or interrupted urine flow
* Pain or a burning sensation during urination
* Difficulty in obtaining an erection
* Pain during ejaculation
* Blood in the urine or in semen
* Recurring pain or stiffness in the lower back, hips, or upper thighs
Sometimes the first symptoms will be lower back, hip or pelvic pain caused by cancer which has already spread.
It is important to be aware that the symptoms of both benign enlargement of the prostate gland (i.e. non-cancerous) and malignant tumours (cancer) are similar and might include any of the following symptoms:
* Difficulty starting urination
* Frequent urination, particularly at night
* Pain during urination
* Blood in the urine
Also, men over 50 years of age often have an enlarged prostate gland due to the non-cancerous condition of benign prostatic hyperplasia (BPH), or hypertrophy.
Therefore if you notice any of the above symptoms it is important that you see your doctor and have them investigated. But note that most enlargements of the prostate are not due to cancer and can regularly be dealt with quite effectively.
EARLY DIAGNOSIS OF PROSTATE CANCER
Prostate cancer can often be discovered at an early stage by testing the amount of prostate specific antigen (PSA) in the blood. Prostate cancer can also be detected early by your doctor performing a digital rectal examination (DRE). Since the prostate gland is situated close to the rectum, a doctor can physically detect if there are any cancerous signs in your prostate.
Unfortunately the PSA and DRE tests are not totally accurate and conclusive. This can lead to anxiety and confusion, or even to a false sense of security. So important things to consider are your age, your general health and your lifestyle. If you are young and develop prostate cancer, if not caught early enough, it could shorten your life. If however you are older or in poor health, then prostate cancer might never become a serious problem due to its slow-growing nature.
The American Cancer Society recommends that men commence having the prostate specific antigen (PSA) blood test and digital rectal examination (DRE) annually from the age of 50. Those at higher risk, such as African Americans and those with close relatives who developed prostate cancer at an early age are recommended to commence testing at 45.
The prognosis for prostate cancer sufferers has improved dramatically in recent years. In the past twenty years the overall survival rate for all stages of prostate cancer has increased from 67% to 97%. Thus more men are living significantly longer after diagnosis. In all likelihood this is due to early detection programs, increased public awareness, particularly of prostate cancer symptoms, and the adoption of healthier lifestyles.
Diagnosis Of Prostate Cancer
The diagnosis of prostate cancer can be made on clinical suspicion of the disease, following screening, or as an incidental finding during transurethral resection for suspected benign disease (TURP).
Clinically suspected prostate cancer Prostate cancer can be completely asymptomatic or present with symptoms similar to benign prostatic enlargement (see symptoms). It can also present with the symptoms of metastatic disease. On digital rectal examination prostate cancer feels rock hard and nodular. Invasion into the surrounding structures may be palpable as a hard mass. Spread to the lymph glands may be palpable in the groins or pelvis. Bony metastases to the lumbar spine or pelvis are often tender to palpation. PSA (Prostate Specific Antigen) is a substance excreted by all prostate cells. The blood level of PSA is elevated in prostate cancer and the level of elevation correlates with the extent of disease. The PSA level can also be elevated by benign diseases such as prostatitis and benign prostatic hyperplasia. The normal range for PSA is 0 – 4 ng/ml. The higher the PSA the greater is the chance of having prostate cancer. Somebody with a PSA of 4 – 10 ng/ml has a 25% chance of having prostate cancer, while a PSA of greater than 10 carries a 50% risk of the disease. Very high levels of PSA (>100ng/ml) almost invariably indicate widespread metastatic disease. The diagnosis of prostate cancer is confirmed by needle biopsy and histological analysis of the biopsy specimens. A transrectal ultrasound scan is performed via a probe inserted into the rectum, and ultrasound guided needle biopsies of the prostate are taken. The procedure is performed under local anaesthetic.
Screening All healthy men over the age of 50 years should have annual prostate cancer checks. Black men and men with a positive family history should start at age 40. The aim of screening is to diagnose the disease at an early stage while it is still potentially curable. By the time prostate cancer becomes symptomatic it is usually beyond cure. The screening tests consist of a digital rectal examination and a PSA blood test. The prostate gland may feel entirely normal despite the presence of an early cancer. The combination of PSA and digital rectal examination is more sensitive than either test alone. If one or both of these tests are abnormal a transrectal ultrasound and needle biopsies of the prostate gland are performed.
Incidental finding following TURP Whenever a transurethral resection of the prostate gland is performed for suspected benign disease the removed tissue is sent for histological analysis. Occasionally evidence of unsuspected prostate cancer is found in the tissue. In a young man with an otherwise long life expectancy this is obviously significant. A tiny focus of cancer in an elderly man is probably not significant, since the prostate cancer will not have sufficient time to become bothersome.
With our next information – we will inform you about the “Diagnosis of prostate cancer” – so you should have a look on this site in the next 2 weeks! If you have any question sends us your e-mail.
