Stephen J. Schueler, M.D.

Cancer Prostate Evaluation

The evaluation of prostate cancer begins with a history and physical exam, including a rectal examination.

Physical findings in someone with prostate cancer during rectal examination may include:

Tests that may be used to evaluate prostate cancer include:

Cancer Prostate Biopsy

The diagnosis of prostate cancer is usually confirmed by performing a needle biopsy of the prostate gland. During a prostate biopsy, a needle is inserted through the rectum and advanced into the prostate gland. Ultrasound is used to guide the needle during the biopsy. A small tissue sample is collected, and then studied under a microscope to look for cancer cells. Usually, the biopsy is performed as an outpatient procedure, under local anesthesia.

Side effects of a prostate biopsy include:

Side effects are mild, and resolve completely within 2 weeks.

Cancer Prostate Psa Level

The prostate specific antigen or PSA test is an important test to detect prostate cancer, as well as monitor the progress of prostate cancer treatment.

The prostate specific antigen blood test measures a protein that is made by the prostate gland. PSA is increased in males who have prostate cancer.

A normal PSA level is lower than 4 nanograms per milliliter (ng/ml). About one-quarter of men with borderline PSA elevations (4.1 to 10.0 ng/ml) have prostate cancer. Almost two-thirds of those with PSA levels of 10 ng/ml, or higher, have prostate cancer. Very high PSA levels suggest the presence of advanced cancer.

PSA testing is recommended annually for all men over the age of 50. If you are under 50 years old, your doctor can decide whether you require PSA testing.

Additional testing for prostate cancer may be required in the following situations:

  • PSA level over 4.0 ng/ml in males over 50
  • PSA level over 2.5 ng/ml in males under 50
  • PSA level rises more than 20 percent in one year
  • PSA level rises more than 0.75 ng/ml in one year

Cancer Prostate Staging

Prostate cancer is grouped into stages, based on its severity and spread to other areas of the body.

The staging system helps doctors determine the best treatment for the cancer.

Cancer Prostate Stage 1

Stage T1 Prostate Cancer Features:

  • In stage T1, microscopic prostate cancer is detected during a biopsy.
  • The cancer cannot be detected by physical exam or ultrasound.

Cancer Prostate Stage 2

Stage T2 Prostate Cancer Features:

  • In stage T2, the prostate cancer is confined to the prostate.
  • It is large enough to be detectable by physical exam or ultrasound.

Cancer Prostate Stage 3

Stage T3 Prostate Cancer Features:

  • In stage T3, the prostate cancer has spread to the seminal vesicles, which transport sperm from the testicles.

Cancer Prostate Stage 4

Stage T4 Prostate Cancer Features:

  • In stage T4, the prostate cancer has spread to the bladder.

Cancer Prostate Stage M

Stage M Prostate Cancer Features:

  • Stage M determines whether the cancer has spread, or metastasized, to distant areas of the body.
  • It has groups of M0 through M1c, depending on the degree of spread:
    • M0: no distant spread
    • M1: distant metastases (area not specified)
    • M1a: metastases to distant lymph nodes
    • M1b: metastases to bones
    • M1c: metastases to other organs

Cancer Prostate Stage N

Stage N Prostate Cancer Features:

  • Stage N describes spread to the lymph nodes that are near the prostate.
  • It has groups of N0 through N3, depending on the degree of spread:
    • N0: no local lymph node involvement
    • N1: single node involved, less than 2 cm in size
    • N2: one or more nodes up to 5 cm in size
    • N3: larger than 5 cm in any node

Continue to Cancer Prostate Treatment

Last Updated: Jan 3, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Cancer Prostate References
  1. Alibhai SM, Klotz LH. A systematic review of randomized trials in localized prostate cancer. Can J Urol. 2004 Feb;11(1):2110-7. [15003149]
  2. Astorg P. Dietary N-6 and N-3 polyunsaturated fatty acids and prostate cancer risk: a review of epidemiological and experimental evidence. Cancer Causes Control. 2004 May;15(4):367-86. [15141138]
  3. Dagnelie PC, Schuurman AG, Goldbohm RA, Van den Brandt PA. Diet, anthropometric measures and prostate cancer risk: a review of prospective cohort and intervention studies. BJU Int. 2004 May;93(8):1139-50. [15142129]
  4. Johns LE, Houlston RS. A systematic review and meta-analysis of familial prostate cancer risk. BJU Int. 2003 Jun;91(9):789-94. [12780833]
  5. Mahmud S, Franco E, Aprikian A. Prostate cancer and use of nonsteroidal anti-inflammatory drugs: systematic review and meta-analysis. Br J Cancer. 2004 Jan 12;90(1):93-9. [14710213]
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