Prostate Cancer Screening FAQs

by | Nov 9, 2018 | Prostate Cancer

Prostate cancer is the second leading cause of cancer-related deaths among American men. Men with family histories of prostate cancer or those who have been presenting symptoms that could be prostate cancer should consider getting screened. But what exactly does screening entail? Here are some FAQs about prostate cancer screening you may want to ask your doctor.

What is a PSA (Prostate Specific Antigen) test?

A PSA test checks a blood sample for the level of PSA, a substance produced by the prostate gland. If the PSA test detects a higher than normal value (above 4.0ng/ml), it may indicate prostate infection, enlargement of the prostate gland, or cancer.

What other screenings are can detect prostate cancer?

There are two categories of screening tests – one that screens for prostate cancer and another that helps determine the stage of the disease. These tests include:

·      Digital rectal exam (DRE), in which a doctor inserts a gloved, lubricated finger into the rectum to examine the prostate gland, looking for abnormalities in texture, shape or size.

·      Transrectal ultrasound, in which a small probe that emits sound waves is inserted into the rectum to produce an image of the prostate gland.

·      A prostate biopsy involves the removal of 6-12 small pieces of the prostate for pathological evaluation. These tissue samples provide a diagnosis of prostate cancer and the grading of the cancer, known as the Combined Gleason Score or CGS.

How are the stages of prostate cancer determined?

Stages of prostate cancer are determined by whether the cancer is confined to the prostate or has spread beyond the prostate and where it has spread to.

What are the different stages of prostate cancer?

There are several staging systems for prostate cancer. The most widely used system is the TNM system, which describes the extent of the primary tumor (T stage), whether the cancer has spread to nearby lymph nodes (N stage), and the absence or presence of distant metastasis (M stage). “Metastasis” refers to the spread of cancer cells from the prostate gland to another part of the body.

There are four categories that describe the prostate tumor’s (T) stage, ranging from T1 to T4, or Stage A to D, indicated as follows:

–       T1/Stage A: The cancer is microscopic, unilateral and non-palpable.

–       T2/Stage B: The doctor can feel the cancer with a DRE. The disease is confined to the prostate gland on one or both sides.

–       T3/Stage C: The cancer has advanced to tissue immediately outside the gland.

–       T4/Stage D: The cancer has spread to other parts of the body.

What are Gleason Grade scores?

Gleason grade scores range from 1 to 5 and are based on the degree of differentiation among the cells as follows:

–       Grade 1 – Small, uniform cells, tightly packed.

–       Grade 2 – Varied cell sizes and shapes, loosely packed.

–       Grade 3 – Increased cell size and shape irregularity, less distinction between cells.

–       Grade 4 – Large, irregular fused cells.

–       Grade 5 – Irregular, fused cells that have invaded surrounding connective tissue cells,

How is the cancer stage (T) determined?

By touch, the doctor can tell if the cancer is T1, T2, or beyond T2. Also, a biopsy sample is evaluated by a pathologist who assigns a CGS score ranging from 2 through 10. The higher the number, the more aggressive the cancer.

How can you determine if the cancer has spread?

A Prostatic Acid Phosphatase (PAP) blood test can determine if the cancer has spread beyond or is confined to the prostate. Both a computed tomography (CT) scan and magnetic resonance imaging (MRI) can help determine if the prostate cancer has spread to other organs.

A Radionuclide bone scan can determine whether cancer has spread from the prostate to the bones.

A ProstaScint scan can detect the spread of prostate cancer to lymph nodes and other soft (non-bone) organs, but its sensitivity and specificity are relatively low. A lymph node sampling is another way of finding if the cancer has spread to nearby lymph nodes and is typically performed when there is a high suspicion of spreading.

How is prostate cancer treated?

Treatment for prostate cancer depends on the stage of the cancer, your age and overall health. For men who are at a high risk, traditional treatment includes surgery, radiation therapy, cryosurgery, hormone therapy and, in some cases, chemotherapy.

Unfortunately, the side effects from these methods can be harsh and emotionally difficult for men. They may include impotence, sterility, incontinence, diarrhea, loss of appetite, fatigue, low blood counts, and an increased risk of infection and bleeding.

Are there any new treatments for prostate cancer?

CyberKnife radiation therapy has proven to be a highly successful treatment for prostate cancer and is rapidly becoming the number one treatment of choice for men. CyberKnife is a non-invasive procedure that reduces the risk of side effects that result from traditional treatments, including surgery and standard radiation.

Despite its name, CyberKnife is not a knife at all. It is cutting-edge radiation technology that’s used to destroy tumors with pinpoint accuracy, leaving surrounding healthy tissue unaffected.

There’s no cutting, incision, blood, anesthesia, pain, or catheters. There are few, if any, side effects and no recovery time. CyberKnife’s robotic missile-guided image technology allows doctors to achieve a high level of accuracy by pinpointing a tumor’s exact location throughout the treatment, resulting in successful outcomes.

If you’ve been diagnosed with prostate cancer and want to find out if CyberKnife treatment is suitable for you, call our center in Miami at (800) 204-0455 or 305-279-200 and contact us online. You can also learn more by visiting us at