Diagnosis and Staging treatment options next steps Other Diseases of the Prostate
cross section showing prostate gland

The prostate is part of the male reproductive system.   It is a walnut-sized gland that is located just below the bladder, at the base of the penis.  The prostate surrounds the urethra – the tube that carries urine from the bladder our through the penis.  Its main function is to produce the fluid that carries sperm when a man ejaculates.


Diagnosis & Staging

Cancer is a disease that starts in our cells.  Our bodies consist of millions of cells that group together to form organs and tissues – lungs, liver, muscles and bones.  Genes inside of each cell tell it when to grow, work, reproduce and die.  Under normal circumstances these orders are very clear; the cells obey them, and we remain healthy.

But when a cell’s instructions get confused, it grows abnormally.  These abnormal cells will form groups over time and result in lumps or tumours.  Sometimes, these abnormal cells will invade the tissues around them and spread to other parts of the body – this is cancer.  Cancerous tumours can be dangerous and it is very important to find them and treat them before they spread.

Cancers are generally named after the body part where they start – most prostate cancer starts in the glandular tissue of the prostate.  It is called ADENOCARCINOMA

Prostate cancer is often slow-growing and can be managed very successfully but it is important to diagnose it early.

Diagnosis

In it's early stages prostate cancer has no symptoms.  It can grow for years without any warning signs.  When symptoms do finally appear, many of them are the same as those caused by urinary blockage or irritation from benign, non-cancerous diseases, such as benign prostatic hyperplasia or prostatitis.

It however must be emphasized that NONE of these symptoms are found only in cancer, and most commonly are caused by benign, non-cancerous disorders, and most men with prostate cancer have no symptoms whatsoever.

Advanced cancer may result in fatigue, loss of energy, persistent swelling of one or both legs and pain in the back, rib or hip.

How can I find out if I have prostate cancer?

During an annual check up, doctors usually do a DRE (digital rectal exam).  If the doctor feels anything unusual, or you have experienced changes in your urination habits, a PSA test may be ordered.  This is a blood test that measures how much prostate specific antigen (PSA) the prostate is producing.  It is the most sensitive test we have for prostate cancer but it can be difficult to interpret.  If levels are higher than normal, it means that there could be a prostate problem – not necessarily cancer.  There could be an infection in the prostate or enlargement that is not cancerous.

If the doctor suspects prostate cancer, he or she may recommend further tests.  A transrectal ultrasound uses sound waves to make a picture of the prostate and allows the doctor to take a biopsy.  The needle biopsy will be used to remove a small amount of tissue and sent to pathology to see if it contains cancer cells.  If cancer is detected by using either of these tests, x-rays and further ultrasounds may also be used to check the stage of your cancer, and this will help to determine treatment options.

Once all of the tests are done and a diagnosis of prostate cancer is confirmed, you will meet with your doctor to decide on treatment.

Why is it important to know the grade and stage of prostate cancer?

The grade and staging of prostate cancer helps the doctor and patient determine which treatment will work best for the individual.  Complete staging may only be possible after surgery or additional tests and it may be necessary to remove some lymph nodes near the cancer to get an accurate picture.

The presence of cancer beyond the prostate has a major impact on treatment.  For patients at risk for spread, further staging tests should be undertaken before a treatment decision is made.  These tests may include a bone scan, CT scan or chest x-ray. 

I have prostate cancer – now what?

Once you have a firm diagnosis of prostate cancer, your doctor, usually your urologist, will sit down with you and to discuss the following eight issues: