Prostate cancer is the second most common cancer (after skin cancer) and one of the leading causes of death for men in Australia. However, as with most cancers, early detection and treatment can significantly reduce the risk of prostate cancer being fatal.
In most cases, prostate cancers found early through screening tests, the two most common being a prostate-specific antigen (PSA) blood test or a digital rectal exam (DRE). If the findings of either of these tests is abnormal then further testing will be required to investigate the possibility of cancer. Let’s take a look at what these tests entail.
Two tests are commonly used to detect prostate cancer early. A PSA blood test or a digital rectal exam.
Prostate-specific antigen (PSA) blood test
PSA is a substance made by cells within the prostate gland. It can be made by both normal cells and cancer cells and can found either in the semen or in the blood. As the name indicates, a PSA test examines PSA levels in the blood.
Levels over 4 nanograms per millilitre of blood may indicate cancer is present. However, this is not a diagnostic test as it only indicates changes in the prostate. There has been some debate over the test as it detects many types of cancer, including many that would have caused no symptoms or harm. This can lead to ‘overdiagnosis’ and unnecessary treatment. PSA levels can be affected by a number of factors too which may also result in overdiagnosis. Two thirds of cases of elevated PSA levels are due to non-cancerous conditions like BPH and prostatitis.
Digital rectal exam (DRE)
A digital rectal exam involves a doctor inserting a gloved, lubricated finger into the rectum to feel for abnormalities on the prostate that might indicate cancer. This is a very short process, and although it can be uncomfortable, it isn’t painful.
This procedure is no longer a routine test in general practice but urologists still perform it as part of a full evaluation for elevated PSA.
If either of these tests discovers anything abnormal then further tests will be required to confirm the presence of cancer. These usually involve an MRI (Magnetic Resonance Imaging) and a prostate biopsy.
Once the MRI has been performed a biopsy is usually required. Dr Arianayagam only uses the most up to date techniques for prostate biopsy – using the transperineal approach or the Mona Lisa Robot. These methods allow for very accurate targeting of the prostate. In addition, the risk of infection is virtually zero as the needles do not pass through the rectum (As in the older transrectal or TRUS technique). Samples are sent to the pathologist and they will examine the tissue for any suggestion of cancer.
If cancer is diagnosed then further staging tests will be arranged. Subsequently, Dr Arianayagam will discuss treatment options that include radiotherapy, seeds and surgery. All relevant patients will also see a radiation oncologist in the Bella Vista rooms in the only private multidisciplinary clinic in Western Sydney.
If you have any further questions about prostate cancer and would like to book an appointment, please feel free to call. Please ensure our receptionist knows that you have a high PSA or a diagnosis of prostate cancer so that we can expedite your appointment.
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