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Prostate Cancer

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Testing/Screening

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Screening and Testing

The overall prognosis for prostate cancer patients has dramatically improved compared with years ago. Over the past 20 years, the overall survival rates for all stages of prostate cancer combined have increased from 67% to 97%. This means more men are living longer after diagnosis. Some of the possible reasons for this increase in survival rates include public awareness and early detection. Prostate Cancer is often curable when diagnosed and treated properly.  Starting at age 50 (or sooner, if you have a history of prostate cancer in your family), the following test should be a part of your annual physical exam:

Blood Test

Prostate Specific Antigen (PSA) Test
This blood test helps identify the possible presence of prostate cancer by checking for Prostate Specific Antigen (a protein substance produced by the prostate gland), which is present in high levels in many people who have Prostate Cancer Prognosis Treatment  The lower the score, the better. A score below 4 is desirable, and a score below 2 is even better. Click here for more information

Free PSA
The free PSA test is another tumor marker.  It's newer than the regular PSA test.  Free PSA is a special version of PSA, specifically, it's the inactive form of the antigen.  Regular PSA tests are used to screen patients for Prostate cancer prognosis treatment, but free PSA can provide extra information, especially in determining whether another biopsy should be performed.  The free PSA test costs around $65 or more (depending on the lab)---about twice the cost of a regular PSA test. (The term free obviously doesn't refer to the test itself!). Unlike regular PSA test, the value is expressed as the free PSA divided by the total PSA, and a low percentage score is bad.  Generally scores of 20 percent and above are considered good, while scores of 15 percent and below mean the chances of cancer are high. Click here for more information

AMAS Test
The Prostate Cancer Prognosis Treatment is one of the best diagnostic aids available today for the early detection and monitoring of cancer. It is superior to conventional blood tests such as the PSA (Prostate Specific Antigen), CEA and CA125, which measure antigen, a cancer indicator that is not detectable until late in the disease. Thus, these tests are especially poorly suited for Prostate cancer prognosis treatment early detection and are not suitable as early biomarkers in chemo prevention.

The AMAS test works by indicating the presence of a cancer-specific antibody, anti-malign. A function of the immune system, anti-malign antibody is released at the onset of cancer. More than 3,314 double-blind studies have proven a direct correlation between the presence of anti-malign antibody and all types of active, none-terminal cancer.

The specificity and 95% to 99% accuracy of the AMAS test permits confirmation of a diagnosis of cancer while reducing or eliminating the need for other traditional detection tests. These include mammograms, biopsies, x-rays, CT scans, MRIs, and other expensive, uncomfortable procedures. It is easy to see that the medical people might want this to be kept secret.

High risk individuals are recommended to begin using the AMAS test as early as age 30. Click here for more information on AMAS test.

Urine Flow Study
Sometimes the doctor will ask a patient to urinate into a special device that measures how quickly the urine is flowing.  A reduced flow often suggest BPH.

Digital Rectal Exam (DRE)
The doctor inserts his lubricated finger into the rectum to feel for lumps on the prostate, which is normally smooth.  Nobody likes this test but it can a life saver.

If the digital rectal exam, PSA, or other indicators (such as urinary symptoms) point to the possibility of prostate cancer, the following tests may be performed.

Biopsy
Procedure where tissue samples form the prostate are removed to be checked for cancer.  Prostate biopsy is recommended when a digital rectal examination reveals a lump or some other abnormality in the prostate. In addition, if blood tests reveal that the levels of certain markers, such as PSA, are above normal, the doctor may order a biopsy.

Prostate biopsies can be performed in three different ways. They can be performed by inserting a needle through the perineum (the area between the base of the penis and the rectum), by inserting a needle through the wall of the rectum, or by cytoscopy. Before the procedure is performed, the patient may be given a sedative to help him relax. Patients undergoing cytoscopy may be given either general anesthesia or local anesthesia. The doctor will ask the patient to have an enema before carrying out the biopsy. The patient is also given antibiotics to prevent any possible infection. Prostate biopsy performed with a needle is a low-risk procedure. The possible complications include some bleeding into the urethra, an infection, or an inability to urinate.

Needle biopsy via the perineum
The patient lies either on one side or on his back with his knees up. The skin of the perineum is thoroughly cleansed with an iodine solution. A local anesthetic is injected at the site where the biopsy is performed. Once the area is numb, the doctor makes a small (1 in) incision in the perineum. The doctor places one finger in the rectum to guide the placement of the needle. The needle is then inserted into the prostate, a small amount of tissue is collected, and the needle is withdrawn. The needle is then re-inserted into another part of the prostate. Tissue may be taken from several areas. Pressure is then applied at the biopsy site to stop the bleeding. The procedure generally takes 15-30 minutes and is usually done in a physician's office or in a hospital operating room. Though it sounds painful, it typically causes only slight discomfort.

Needle biopsy via the rectum
This procedure is also done in the physician's office or in the hospital operating room, and is usually done without any anesthetic. The patient is asked to lie on his side or on his back with his legs in stirrups. The doctor attaches a curved needle guide to his finger and then inserts the finger into the rectum. After firmly placing the needle guide in the rectum, the biopsy needle is pushed along the guide, through the wall of the rectum and into the prostate. The needle is rotated gently, prostate tissue samples are collected and the needle withdrawn.

Cystoscopy
In this exam, the doctor inserts a small tube through the opening of the urethra in the penis.  This procedure is done after a solution numbs the inside of the penis so all sensation is lost.  The tube, called a cystoscope, contains a lens and a light system, which help the doctor see the inside of the urethra and the bladder.  This test allows the doctor to determine the size of the gland and identify the location and degree of the obstruction.

If your biopsy/ tissue samples show the presence of prostate cancer, the pathologist assigns each tissue sample a grade, indicating how far the cells have traveled along the path from normal to abnormal. The grade offers a good clue to your tumor's behavior: a tumor with a low grade is likely to be slow-growing, while one with a high grade is more likely to grow aggressively or already to have spread outside the prostate (metastasized). The most widely used grading method for prostate cancer is known as the Gleason grading system. Click here for more information about the Gleason grading system.

Ultrasound
A test that uses sound waves to check for the presence of tumors.  An external ultrasound may be used in addition to the internal ultrasound.

Imaging Tests

Radionuclide Bone Scan
A bone scan may be performed in addition to a biopsy, to check whether cancer may have spread to the bones.  The procedure involves an intravenous injection of a small amount of a radioactive material. The radioactive substance settles in damaged bone tissue throughout the entire skeleton. Areas of bone damage will be more radioactive and will appear as "hot spots" in your skeleton. These areas may suggest metastatic cancer is present, but arthritis or other bone diseases can also cause the same pattern. To distinguish among these conditions, your cancer care team may use other imaging tests such as simple x-rays, CT, or MRI or even take bone biopsies to better evaluate these hot spots.


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