Cancer of the Prostate

There are a number of different tests which are used to detect prostate cancer although each one of them are not conclusive on their own. The following lists will give a brief description of the examinations which are most commonly used:

Rectal Examination
The doctor/surgeon will insert a gloved finger into the back passage to feel the prostate gland. This will help the doctor to determine whether or not the prostate is larger than normal. If enlarged, it does not necessarily mean that it is cancerous.

PSA Test
This involves a blood test which measures the Prostate Specific Antigen (PSA) in the blood. If the PSA is too high, it might be suggested that prostate cancer has developed although there are several other conditions which may have increased the PSA levels in the blood.

Ultrasound
This involved a small probe being inserted into the back passage for the purpose of an ultrasound scan. This will illustrate the exact size of the prostate.

Biopsy
A biopsy involves a small sample of tissue from around the prostate being taken. This is performed by a probe being inserted into the back passage and a small needle jabbing the prostate.

X-rays
X-rays can illustrate the presence of cancer which has spread from the prostate to the nearby bones.
At present, routine screening for cancer of the prostate are not performed in any country due to the fact that the tests are not accurate enough to be used in general. For example, screening every man by PSA test would highlight many men who did not have cancer and on the other hand many men who do have cancer would go undetected. However, those men who have a family history of prostate cancer may benefit from certain screening. This should be discussed with your doctor.

Prostate cancer is detected in more than half of those patients who develop it at an early stage making treatment for successful for nine out of ten cases. The other half of patients are diagnosed after the cancer has been become advanced and spread. Treatment can provide those patients with several extra years of life and prevent pain of the disease, although it does not normally provide a cure. 

Some prostate cancers grow fairly slowly, therefore no treatment is required. Where treatment is required, three main methods are used:

Surgery
Surgery known as prostatectomy where the whole of the prostate is removed.

Radiotherapy
During radiation treatment, high energy rays are used to kill the cancerous cells. This also helps to destroy the originating tumour and helps to reduce the pain which have been caused by the cancerous tumour cells which have spread to the bones.

Brachytherapy
This newer type of radiotherapy consists of small radioactive wires or pellets being inserted directly into the tumour, killing it from the inside. This has found to be as effective as other available treatments, sometimes even more so. It has also been found that there are fewer side effects from this type of treatment. 

Hormone Therapy
The growth of the cancer cells in the prostate depends on the male hormones, known as androgens. There are certain drugs available which reduce the amount of androgens which are produced by the body. They also work by blocking the effect of androgens on the cancer cells. This then prevents the growth of the tumour or shrinks it. It has been found, however, that most prostate cancers, after approximately five years go on to develop the ability to develop without androgens thus the hormone therapy stops working.

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