Prostate Cancer
Prostate Cancer
The prostate is a male sex gland, about the size of a walnut. It produces a thick fluid that helps propel sperm through the urethra and out of the penis during sex. Because the prostate is just below the bladder and directly in front of the rectum, a doctor can check the size and condition of the gland by inserting a rubber-gloved finger into the rectum. This digital rectal exam (DRE) has for years been the gold standard for detecting prostate cancer as well as the noncancerous disorder benign prostatic hyperplasia (BPH).
In 1985, FDA approved the first test for monitoring blood levels of a substance called prostate specific antigen (PSA), which, when elevated, can indicate cancer presence. Several companies now have approved PSA tests, which, experts say, have revolutionized the screening and monitoring of patients.
PSA is an ideal marker for prostate cancer because it is basically restricted to prostate cells. A healthy prostate will produce a stable amount -- typically below 4 nanograms per milliliter, or a PSA reading of "4" or less -- whereas cancer cells produce escalating amounts that correspond with the severity of the cancer. A level between 4 and 10 may raise a doctor's suspicion that a patient has prostate cancer, while amounts above 50 may show that the tumor has spread elsewhere in the body.
Most PSA tests measure "total PSA," or the amount that is bound to blood proteins. In March, FDA approved the Tandem R test, which measures not only total PSA but another component called "free PSA," which floats unbound in the blood. Comparing the two helps doctors rule out cancer in men whose PSA is mildly elevated from other causes. A 1995 study in the Journal of the American Medical Association showed that the free PSA test can reduce unnecessary prostate biopsies by 20 percent in patients with a PSA between 4 and 10.
The availability of increasingly sensitive testing devices has created a debate over when men should be tested for prostate cancer, how often, and whether men under 50 with no symptoms should be routinely screened. Opponents say mass screening would be expensive, and the verdict is still out on whether early detection can curb the disease's mortality rate. But proponents say early detection is the closest thing currently to a cure and that it can save lives. The American Cancer Society and the American Urological Association recommend annual PSA tests -- along with the digital exam -- for all men over 50 and for high-risk men over 40.
In this article
- Detecting Prostate Cancer
- Stages of Prostate Cancer
- Treating the Disease
- Looking Ahead
- Out in the Open
- For More Information
Detecting Prostate Cancer
The prostate is a male sex gland, about the size of a walnut. It produces a thick fluid that helps propel sperm through the urethra and out of the penis during sex. Because the prostate is just below the bladder and directly in front of the rectum, a doctor can check the size and condition of the gland by inserting a rubber-gloved finger into the rectum. This digital rectal exam (DRE) has for years been the gold standard for detecting prostate cancer as well as the noncancerous disorder benign prostatic hyperplasia (BPH).
In 1985, FDA approved the first test for monitoring blood levels of a substance called prostate specific antigen (PSA), which, when elevated, can indicate cancer presence. Several companies now have approved PSA tests, which, experts say, have revolutionized the screening and monitoring of patients.
PSA is an ideal marker for prostate cancer because it is basically restricted to prostate cells. A healthy prostate will produce a stable amount -- typically below 4 nanograms per milliliter, or a PSA reading of "4" or less -- whereas cancer cells produce escalating amounts that correspond with the severity of the cancer. A level between 4 and 10 may raise a doctor's suspicion that a patient has prostate cancer, while amounts above 50 may show that the tumor has spread elsewhere in the body.
Most PSA tests measure "total PSA," or the amount that is bound to blood proteins. In March, FDA approved the Tandem R test, which measures not only total PSA but another component called "free PSA," which floats unbound in the blood. Comparing the two helps doctors rule out cancer in men whose PSA is mildly elevated from other causes. A 1995 study in the Journal of the American Medical Association showed that the free PSA test can reduce unnecessary prostate biopsies by 20 percent in patients with a PSA between 4 and 10.
The availability of increasingly sensitive testing devices has created a debate over when men should be tested for prostate cancer, how often, and whether men under 50 with no symptoms should be routinely screened. Opponents say mass screening would be expensive, and the verdict is still out on whether early detection can curb the disease's mortality rate. But proponents say early detection is the closest thing currently to a cure and that it can save lives. The American Cancer Society and the American Urological Association recommend annual PSA tests -- along with the digital exam -- for all men over 50 and for high-risk men over 40.