Early Diagnosis and Treatment of Cancer Series: Prostate Cancer

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Urine test can help diagnose aggressive prostate cancer

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Thank you for taking the time to provide feedback. It will be used to make improvements to this website. Health has a new website. Visit our new website. Australian Government Department of Health. Find out more about prostate cancer symptoms. There are no tests available with sufficient accuracy to screen populations of men for early signs of prostate cancer.

However, early detection and treatment can significantly improve prostate cancer survival. The test most commonly used to aid early detection of prostate cancer is the prostate specific antigen PSA blood test. This is not a diagnostic test as it can only indicate changes in the prostate.

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If you are concerned about prostate cancer you should talk to your doctor and make an informed choice about whether to have one of the tests designed to find early signs of prostate cancer, in view of the potential risks and benefits. For more information see our page on early detection of prostate cancer. If your doctor suspects you may have prostate cancer, you may have one or more of the following tests:.

A prostate specific antigen PSA blood test measures the PSA levels, the proteins made by both normal and cancerous prostate cells.

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Because PSA levels can be variable, it is common for your doctor to use results from more than one blood test, over time, to help determine your risk of prostate cancer. Some men with prostate cancer have normal PSA levels, and only one in three men with an elevated PSA level has cancer. As it is not a definitive test, a PSA test is normally used with other tests to diagnose prostate cancer. There is a lot of confusion around PSA testing. Click here for more information. A biopsy removes small pieces of tissue from different parts of the prostate with the aid of a rectal ultrasound, for examination under microscope.

It is used to detect the disease and determine its aggressiveness the Gleason score of is added from two samples to form a score out of 10; low scores of 6 or less, indicate slow growing disease. If cancer is detected in your prostate, you may have other tests such as MRI, CT or bone scans to see if the disease is contained to the prostate or to help with management and treatment options.

DRE is no longer recommended as a routine test for men who do not have symptoms of prostate cancer. It is still useful for men who want to be tested for the presence of prostate cancer.


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Ninety per cent of patients present with local disease. Bone and CT scans are used to determine spread. Active surveillance monitors prostate cancer that is not causing symptoms and is considered low risk ie cancer is small and slow growing and unlikely to spread. Generally active surveillance involves PSA tests every months, rectal examination every 6 months and MRI scans and biopsies at 12 months and 3 years.

Watchful waiting is another form of monitoring prostate cancer that involves regular PSA tests and check-ups.

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Watchful waiting can be suitable for older men where the cancer is not likely to cause a problem in their lifetime. Surgery with curative intent removes the whole prostate radical prostatectomy.

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The main side-effects may include impotence and incontinence. Radical radiotherapy can also be given with curative intent, either with external radiation or by implanting radioactive seeds brachytherapy.

Side-effects are similar to surgery, however bowel problems may also occur. Some cancers need certain hormones to grow. Prostate cancer needs testosterone. Androgen deprivation therapy or ADT once called hormone therapy is used to slow the production of testosterone.

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  6. ADT is often used before, during and after radiotherapy and is sometimes given with chemotherapy. ADT can be given with injections or in tablet form. Surgery to remove part or all of the testicles may be preferable in some cases.