Prostate cancer affects one in six men during their life and is the second most common cancer in American men.
Risk factors
Risk factors for developing prostate cancer include older age, African American race, positive family history, and excess weight.
Symptoms
Typically, men diagnosed with prostate cancer do not have symptoms because prostate cancer is typically caught early. If found later after the cancer has grown or spread, men may have symptoms of trouble urinating, blood in the urine (hematuria), or back, thigh, or hip pain.
Testing
Testing for prostate cancer can involved various exams. Typically, screening for prostate cancer is done with a blood test and an prostate exam (rectal examination). Prostate specific antigen (PSA) is a blood test often used to screen men for prostate cancer. A higher level may indicate that prostate cancer is present, although there are other non-cancerous causes for a increased PSA level. While the timing of obtaining a PSA in men may vary, typically PSA screening is done beginning at age 45 to 55 based on risk factors. A higher PSA level or an abnormal prostate exam may require further evaluation with a prostate biopsy. While PSA screening is simple and can find prostate cancer early before it becomes incurable, it can also find cancer that will not spread or cause problems.
Procedures
Various procedures are used to diagnose and treat prostate cancer. Of these, the most common procedure used is a prostate biopsy.
Prostate biopsy
A prostate biopsy is a medical procedure that allows your doctor to evaluate for prostate cancer. The procedure is done in an office using numbing medication or in an outpatient surgery center using sedation. During the procedure, your doctor will insert a small ultrasound probe into your rectum. Immediately prior to the procedure, a lubricating jelly is used to allow easy passage of the ultrasound probe. The prostate is visualized, and samples of the prostate gland are obtained. The number of biopsies obtained may vary, but typically at least twelve samples are obtained. These samples are then sent to a pathologist to review to see if cells look abnormal or cancerous. Typically, a prostate biopsy takes 5-10 minutes to complete.
Fusion prostate biopsy
Fusion prostate biopsy is the most advanced technique for prostate cancer detection, improving the accuracy and detection of prostate cancer. Using a multi-parametric MRI (mpMRI) of the prostate, your doctor can precisely target suspicious areas in the prostate gland. This allows for a more accurate biopsy. Patients first have an MRI of the prostate. The MRI is reviewed by a radiologist, who identified suspicious areas within the prostate. The MRI is then fused with the ultrasound image in real time during the biopsy performed by your doctor, allowing precise targeting of the concerning areas.