If initial screenings indicate that prostate cancer may be present, your doctor will conduct further tests to confirm whether or not the prostate is healthy.
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Signs & Symptoms
Most prostate cancer symptoms affect urination. These include:
- Frequent urination
- Weak urine flow
- Pain when urinating
- Inability to urinate
- Blood in urine or semen
- Painful ejaculation
- Erectile dysfunction
Oftentimes, early prostate cancer causes no symptoms, and these symptoms can be similar to other conditions such as benign prostatic hyperplasia (BPH). Talk to your doctor if you have any concerns.
The Prostate Cancer Antigen 3 (PCA3) is a gene that cancerous prostates produce in excess. The PCA3 test is a simple urine test. Doctors use PCA3 results to help them decide if a biopsy is necessary.
An ultrasound uses sound waves and echoes to create a black-and-white image or map of the inside of the body. In order to conduct a transrectal ultrasound (TRUS) on the prostate, the doctor inserts a probe that has a small ultrasound transducer on the end into the rectum. The images that the ultrasound returns help the doctor confirm his or her findings
A biopsy is the removal of a small amount of tissue to test for disease. In the case of a prostate biopsy, the doctor will insert a hollow needle with a through the rectum and into the prostate to obtain several samples. Typically, the biopsy is performed at the same time as the TRUS.
The samples are sent to a laboratory where a pathologist searches for cancer cells in the samples under a microscope.
Because biopsy samples are so small, it is possible to miss the cancer cells, and return what’s called a “false negative.” If your other screening and test results lead your doctor to believe that cancer is present and the first biopsy simply missed the cancerous cells, he or she may order another biopsy.
The pathologist who studied the biopsy will send a report to your doctor. If the pathologist finds cancer cells, he or she assigns them a Gleason score between 1 and 5. A sample with a Gleason score of 1 looks close to normal, healthy tissue, while a score of 5 looks very abnormal. The report will also include predictions on how likely the cancer is to grow, spread throughout the body and recur after treatment. Your doctor will use this information to craft a tailored treatment plan.