How is prostate cancer diagnosed? What tests are used? Who should get screened? Explore the details of prostate cancer diagnosis and treatment options.

Understanding Prostate Cancer

Prostate cancer is the second most common cancer among men in the United States, after skin cancer. It starts in the prostate gland, which is part of the male reproductive system. The gland produces a fluid that, together with sperm from the testicles, makes up semen. Muscle cells inside the prostate play a role in ejaculation.

The American Cancer Society (ACS) estimates that in 2019, there will be 174,650 new prostate cancer diagnoses in the U.S. and around 31,620 people will die from this type of cancer during the year. Additionally, the ACS notes that 1 in 9 men will be diagnosed with prostate cancer during their lifetime, and around 1 in 41 men will die from the disease. However, with proper treatment, there is a good chance of surviving prostate cancer.

Screening for Prostate Cancer

Prostate cancer often produces no symptoms in the early stages, so regular screening is crucial. Doctors commonly use two main tests to screen for prostate cancer:

1. Digital Rectal Exam (DRE): This is a physical examination where the doctor inserts a gloved, lubricated finger into the rectum to feel the prostate gland for any abnormalities.
2. Prostate-Specific Antigen (PSA) Test: This blood test measures the amount of PSA, a protein produced by the prostate gland, in the bloodstream. High levels of PSA can indicate the presence of prostate cancer.

Neither the DRE nor the PSA test can confirm the presence of prostate cancer, as various other factors may influence the results. However, these tests can indicate whether further steps, such as a prostate biopsy, are necessary.

The Digital Rectal Exam (DRE)

Before the DRE, the person should ask the healthcare team questions about the procedure, such as what will happen, how long it will take, if it will be painful, and how accurate it is in finding cancer. The person should also inform the team if they have any existing conditions like hemorrhoids or anal fissures, as the DRE may aggravate these.

During the DRE, the person may be instructed to lie on their left side with their knees pulled up to their chest, or to stand and lean against a table. The doctor will put on gloves, apply lubricant, and gently insert a finger into the rectum to assess the size and feel of the prostate gland, checking for any abnormalities.

The DRE is not usually painful, but it may be slightly uncomfortable. It typically takes only a few minutes to complete. After the exam, the doctor will explain the results, and the person may also undergo a PSA test on the same day.

The Prostate-Specific Antigen (PSA) Test

The PSA test involves taking a blood sample and analyzing it to measure the amount of prostate-specific antigen (PSA) in the bloodstream. Some key points about the PSA test:

• Normal PSA levels are typically below 4 nanograms per milliliter (ng/ml).
• Borderline PSA levels of 4-10 ng/ml indicate a 1 in 4 chance of cancer being present.
• High PSA levels above 10 ng/ml suggest a 50% chance of prostate cancer.

It’s important to note that high PSA levels do not necessarily mean cancer is present, as various other conditions and factors can also raise PSA levels.

Confirming Prostate Cancer Diagnosis

If the DRE or PSA test results suggest the possibility of prostate cancer, the next step is usually a prostate biopsy. This is the only way to confirm a prostate cancer diagnosis. During a biopsy, the doctor uses a thin, hollow needle to take small samples of tissue from the prostate gland, which are then analyzed in a laboratory.

The results of the biopsy will determine whether prostate cancer is present and, if so, the stage and grade of the cancer. This information is crucial in determining the appropriate treatment plan.

Treatment Options for Prostate Cancer

The treatment for prostate cancer depends on various factors, including the stage and grade of the cancer, the person’s age, overall health, and personal preferences. Some common treatment options include:

• Active Surveillance: For low-risk, early-stage prostate cancers, the doctor may recommend regular monitoring and delaying treatment unless the cancer shows signs of progression.
• Surgery: Surgical options include radical prostatectomy (removal of the prostate gland) and minimally invasive procedures like robotic-assisted laparoscopic prostatectomy.
• Radiation Therapy: External beam radiation therapy and brachytherapy (internal radiation) are common radiation treatment options.
• Hormone Therapy: Medications that lower testosterone levels can slow the growth and spread of prostate cancer.
• Chemotherapy: Chemotherapy drugs may be used to treat advanced or aggressive prostate cancers.

The healthcare team will work closely with the patient to determine the best treatment plan based on the specific circumstances and the patient’s preferences.

How is it done and who should have one?

Prostate cancer is the second leading cause of cancer among adult males in the United States, after skin cancer. However, it is highly treatable, especially in the early stages.

Prostate cancer starts in the prostate gland, which is part of the male reproductive system. The gland produces a fluid that, together with sperm from the testicles, makes up semen. Muscle cells inside the prostate play a role in ejaculation.

The American Cancer Society (ACS) expect that there will be 174,650 new prostate cancer diagnoses in the U.S. in 2019 and that around 31,620 people in the country will die from this type of cancer during the year.

The ACS also note that 1 in 9 men will receive a diagnosis of prostate cancer during their lifetimes, and around 1 in 41 men will die from the disease. With treatment, there is a good chance of surviving prostate cancer.

Prostate cancer often produces no symptoms in the early stages. After a certain age, the doctor may recommend regular screening. A prostate exam can help detect cancer while it is still highly treatable, even if symptoms are not present.

Share on PinterestA doctor can advise on the main methods of screening for prostate cancer.

Screening involves looking for early signs of a disease in people who do not have any symptoms. Cancer screening aims to detect telltale changes at an early stage, when treatment is more likely to be effective.

Doctors commonly use two main tests to screen for prostate cancer:

• the digital rectal exam (DRE)
• the prostate-specific antigen (PSA) test

Neither test can confirm that prostate cancer is present, as various other factors may influence results. However, these tests can indicate whether further steps are necessary.

A prostate biopsy is the only way to confirm that a person has prostate cancer.

Before undergoing either of these tests, the person will need to give consent, which involves confirming that they understand the potential benefits and risks.

The DRE is a physical examination for changes in the prostate that could indicate a tumor.

Before the DRE

Common questions to ask before a DRE include:

• What will happen during the DRE?
• How long will it take?
• Will it be painful?
• How accurate is a DRE, in terms of finding cancer?
• What will happen next?

The individual should also:

Inform their healthcare team if they have hemorrhoids or anal fissures, as a DRE may exacerbate these.

Ask their insurance provider about coverage and whether there will be additional costs.

During the DRE

The procedure usually requires the person to undress from the waist down.

The specialist may instruct the person to lie on their left side and pull their knees up to their chest or to stand and lean against a table.

The specialist will:

• put on some gloves and put lubricant on one finger
• assess the area around the rectum for anything unusual
• gently insert a lubricated, gloved finger into the rectum
• feel the prostate to assess the size and check for bumps, soft or hard spots, and other abnormalities

A DRE is not usually painful, but it may be slightly uncomfortable. It takes only a few minutes to complete.

After the DRE

After the exam, the doctor will explain the results.

The person can usually go back to their regular activities immediately after a DRE.

However, there may be some bleeding from the rectum afterward, particularly if the person has hemorrhoids or anal fissures. If bleeding persists or is significant, the person should contact their healthcare provider.

DRE results

The doctor will usually explain the results of the DRE after the exam.

The person may also undergo a PSA test on the same day. If the doctor believes that further steps may be necessary, they will base this on the results of both the PSA and DRE.

It is worth noting that a DRE often produces a false-positive result. If the doctor detects changes in the prostate gland, this does not necessarily indicate cancer.

Prostate nodules can develop because of prostate cancer or other prostate-related conditions. Learn more about prostate nodules here.

This blood test measures the amount of PSA that the prostate gland produces. Some of this antigen leaks into the blood and will show up during testing.

High levels of PSA in the blood can indicate prostate cancer, but various other conditions and factors can raise PSA levels. High levels do not necessarily mean that cancer is present.

What does the PSA test involve?

The PSA test involves taking a blood sample and sending it to a laboratory for analysis. The results indicate:

Normal levels: Most healthy adult males have PSA levels below 4 nanograms per milliliter (ng/ml).

Borderline levels: PSA levels of 4–10 ng/ml are borderline. There is a 1 in 4 chance that cancer is present.

High levels: If PSA levels are over 10 ng/ml, there is a 50% chance that the person has prostate cancer. The specialist will likely recommend more testing, including a prostate biopsy.

It is important to note that PSA levels can naturally vary from person to person. A person with high levels may not have prostate cancer. On the other hand, about 15% of people who test positive for prostate cancer after a biopsy have PSA levels below 4 ng/ml.

Prostate cancer is not the only cause of high PSA levels. Find out more about the other causes here.

What do the results mean?

PSA levels may be above the baseline for various reasons other than prostate cancer.

Other factors that can raise PSA levels include:

• older age
• recent ejaculation
• medical procedures, including a DRE, a biopsy, or some urological investigations
• testosterone supplementation
• an enlarged prostate — because of benign prostatic hyperplasia (BPH), for example
• prostatitis, which is inflammation and swelling of the prostate

Also, people with obesity may have lower PSA readings.

In addition, some medications may reduce PSA levels, including:

• 5-alpha reductase inhibitors, which can help treat BPH
• aspirin, which some people take regularly as a blood thinner
• statins, which help manage cholesterol levels
• thiazide diuretics, a kind of water pill that can help reduce high blood pressure

Some herbal medicines and supplements can also lower PSA levels. Tell the doctor about any medications and supplements before undergoing the test.

High PSA levels alone do not indicate cancer. However, if a DRE also reveals changes, a doctor may recommend a biopsy for a more accurate result.

The PCA3 is another test for prostate cancer that doctors use in some circumstances. Find out more.

What happens next?

If the DRE and PSA tests show nothing unusual, the healthcare provider may recommend monitoring by repeating one or both tests every 1–2 years.

If the results could indicate prostate cancer, the doctor may recommend a biopsy.

A prostate biopsy can lead to complications. What are the alternatives?

There are no official guidelines about screening for prostate cancer, but the ACS recommend talking to a doctor about screening from the following ages:

• 50 years for males with an average risk and a life expectancy of more than 10 years
• 45 years for those with a high risk
• 40 years for people with more than one close relative who developed prostate cancer at an early age

People who have a high risk include African Americans, people with obesity, and anyone with a close relative who received a diagnosis of prostate cancer before age 65.

Not everyone recommends routine screening, however.

In 2018, the U.S. Preventive Services Task Force recommended that the decision to undergo screening from the ages of 55–69 years should be up to the individual. This is because screening can produce false positive results, leading to investigations or surgery that may not be necessary.

Before going ahead with screening, a person should discuss the risks and benefits with their doctor.

According to the National Cancer Institute, Medicare will cover a yearly PSA test for people 50 and over who are eligible for Medicare.

Does frequent ejaculation lower the risk of prostate cancer? Find out here.

Prostate cancer is common. However, if a doctor diagnoses the cancer while it remains in the prostate or nearby and the person receives treatment, it is almost 100% likely that they will survive for at least another 5 years.

If the cancer spreads to other parts of the body, this survival rate falls to 30%.

A person should start asking about the benefits of screening from age 50, or earlier, if they have a higher risk of prostate cancer.

How is it done and who should have one?

Prostate cancer is the second leading cause of cancer among adult males in the United States, after skin cancer. However, it is highly treatable, especially in the early stages.

Prostate cancer starts in the prostate gland, which is part of the male reproductive system. The gland produces a fluid that, together with sperm from the testicles, makes up semen. Muscle cells inside the prostate play a role in ejaculation.

The American Cancer Society (ACS) expect that there will be 174,650 new prostate cancer diagnoses in the U.S. in 2019 and that around 31,620 people in the country will die from this type of cancer during the year.

The ACS also note that 1 in 9 men will receive a diagnosis of prostate cancer during their lifetimes, and around 1 in 41 men will die from the disease. With treatment, there is a good chance of surviving prostate cancer.

Prostate cancer often produces no symptoms in the early stages. After a certain age, the doctor may recommend regular screening. A prostate exam can help detect cancer while it is still highly treatable, even if symptoms are not present.

Share on PinterestA doctor can advise on the main methods of screening for prostate cancer.

Screening involves looking for early signs of a disease in people who do not have any symptoms. Cancer screening aims to detect telltale changes at an early stage, when treatment is more likely to be effective.

Doctors commonly use two main tests to screen for prostate cancer:

• the digital rectal exam (DRE)
• the prostate-specific antigen (PSA) test

Neither test can confirm that prostate cancer is present, as various other factors may influence results. However, these tests can indicate whether further steps are necessary.

A prostate biopsy is the only way to confirm that a person has prostate cancer.

Before undergoing either of these tests, the person will need to give consent, which involves confirming that they understand the potential benefits and risks.

The DRE is a physical examination for changes in the prostate that could indicate a tumor.

Before the DRE

Common questions to ask before a DRE include:

• What will happen during the DRE?
• How long will it take?
• Will it be painful?
• How accurate is a DRE, in terms of finding cancer?
• What will happen next?

The individual should also:

Inform their healthcare team if they have hemorrhoids or anal fissures, as a DRE may exacerbate these.

Ask their insurance provider about coverage and whether there will be additional costs.

During the DRE

The procedure usually requires the person to undress from the waist down.

The specialist may instruct the person to lie on their left side and pull their knees up to their chest or to stand and lean against a table.

The specialist will:

• put on some gloves and put lubricant on one finger
• assess the area around the rectum for anything unusual
• gently insert a lubricated, gloved finger into the rectum
• feel the prostate to assess the size and check for bumps, soft or hard spots, and other abnormalities

A DRE is not usually painful, but it may be slightly uncomfortable. It takes only a few minutes to complete.

After the DRE

After the exam, the doctor will explain the results.

The person can usually go back to their regular activities immediately after a DRE.

However, there may be some bleeding from the rectum afterward, particularly if the person has hemorrhoids or anal fissures. If bleeding persists or is significant, the person should contact their healthcare provider.

DRE results

The doctor will usually explain the results of the DRE after the exam.

The person may also undergo a PSA test on the same day. If the doctor believes that further steps may be necessary, they will base this on the results of both the PSA and DRE.

It is worth noting that a DRE often produces a false-positive result. If the doctor detects changes in the prostate gland, this does not necessarily indicate cancer.

Prostate nodules can develop because of prostate cancer or other prostate-related conditions. Learn more about prostate nodules here.

This blood test measures the amount of PSA that the prostate gland produces. Some of this antigen leaks into the blood and will show up during testing.

High levels of PSA in the blood can indicate prostate cancer, but various other conditions and factors can raise PSA levels. High levels do not necessarily mean that cancer is present.

What does the PSA test involve?

The PSA test involves taking a blood sample and sending it to a laboratory for analysis. The results indicate:

Normal levels: Most healthy adult males have PSA levels below 4 nanograms per milliliter (ng/ml).

Borderline levels: PSA levels of 4–10 ng/ml are borderline. There is a 1 in 4 chance that cancer is present.

High levels: If PSA levels are over 10 ng/ml, there is a 50% chance that the person has prostate cancer. The specialist will likely recommend more testing, including a prostate biopsy.

It is important to note that PSA levels can naturally vary from person to person. A person with high levels may not have prostate cancer. On the other hand, about 15% of people who test positive for prostate cancer after a biopsy have PSA levels below 4 ng/ml.

Prostate cancer is not the only cause of high PSA levels. Find out more about the other causes here.

What do the results mean?

PSA levels may be above the baseline for various reasons other than prostate cancer.

Other factors that can raise PSA levels include:

• older age
• recent ejaculation
• medical procedures, including a DRE, a biopsy, or some urological investigations
• testosterone supplementation
• an enlarged prostate — because of benign prostatic hyperplasia (BPH), for example
• prostatitis, which is inflammation and swelling of the prostate

Also, people with obesity may have lower PSA readings.

In addition, some medications may reduce PSA levels, including:

• 5-alpha reductase inhibitors, which can help treat BPH
• aspirin, which some people take regularly as a blood thinner
• statins, which help manage cholesterol levels
• thiazide diuretics, a kind of water pill that can help reduce high blood pressure

Some herbal medicines and supplements can also lower PSA levels. Tell the doctor about any medications and supplements before undergoing the test.

High PSA levels alone do not indicate cancer. However, if a DRE also reveals changes, a doctor may recommend a biopsy for a more accurate result.

The PCA3 is another test for prostate cancer that doctors use in some circumstances. Find out more.

What happens next?

If the DRE and PSA tests show nothing unusual, the healthcare provider may recommend monitoring by repeating one or both tests every 1–2 years.

If the results could indicate prostate cancer, the doctor may recommend a biopsy.

A prostate biopsy can lead to complications. What are the alternatives?

There are no official guidelines about screening for prostate cancer, but the ACS recommend talking to a doctor about screening from the following ages:

• 50 years for males with an average risk and a life expectancy of more than 10 years
• 45 years for those with a high risk
• 40 years for people with more than one close relative who developed prostate cancer at an early age

People who have a high risk include African Americans, people with obesity, and anyone with a close relative who received a diagnosis of prostate cancer before age 65.

Not everyone recommends routine screening, however.

In 2018, the U.S. Preventive Services Task Force recommended that the decision to undergo screening from the ages of 55–69 years should be up to the individual. This is because screening can produce false positive results, leading to investigations or surgery that may not be necessary.

Before going ahead with screening, a person should discuss the risks and benefits with their doctor.

According to the National Cancer Institute, Medicare will cover a yearly PSA test for people 50 and over who are eligible for Medicare.

Does frequent ejaculation lower the risk of prostate cancer? Find out here.

Prostate cancer is common. However, if a doctor diagnoses the cancer while it remains in the prostate or nearby and the person receives treatment, it is almost 100% likely that they will survive for at least another 5 years.

If the cancer spreads to other parts of the body, this survival rate falls to 30%.

A person should start asking about the benefits of screening from age 50, or earlier, if they have a higher risk of prostate cancer.

How is it done and who should have one?

Prostate cancer is the second leading cause of cancer among adult males in the United States, after skin cancer. However, it is highly treatable, especially in the early stages.

Prostate cancer starts in the prostate gland, which is part of the male reproductive system. The gland produces a fluid that, together with sperm from the testicles, makes up semen. Muscle cells inside the prostate play a role in ejaculation.

The American Cancer Society (ACS) expect that there will be 174,650 new prostate cancer diagnoses in the U.S. in 2019 and that around 31,620 people in the country will die from this type of cancer during the year.

The ACS also note that 1 in 9 men will receive a diagnosis of prostate cancer during their lifetimes, and around 1 in 41 men will die from the disease. With treatment, there is a good chance of surviving prostate cancer.

Prostate cancer often produces no symptoms in the early stages. After a certain age, the doctor may recommend regular screening. A prostate exam can help detect cancer while it is still highly treatable, even if symptoms are not present.

Share on PinterestA doctor can advise on the main methods of screening for prostate cancer.

Screening involves looking for early signs of a disease in people who do not have any symptoms. Cancer screening aims to detect telltale changes at an early stage, when treatment is more likely to be effective.

Doctors commonly use two main tests to screen for prostate cancer:

• the digital rectal exam (DRE)
• the prostate-specific antigen (PSA) test

Neither test can confirm that prostate cancer is present, as various other factors may influence results. However, these tests can indicate whether further steps are necessary.

A prostate biopsy is the only way to confirm that a person has prostate cancer.

Before undergoing either of these tests, the person will need to give consent, which involves confirming that they understand the potential benefits and risks.

The DRE is a physical examination for changes in the prostate that could indicate a tumor.

Before the DRE

Common questions to ask before a DRE include:

• What will happen during the DRE?
• How long will it take?
• Will it be painful?
• How accurate is a DRE, in terms of finding cancer?
• What will happen next?

The individual should also:

Inform their healthcare team if they have hemorrhoids or anal fissures, as a DRE may exacerbate these.

Ask their insurance provider about coverage and whether there will be additional costs.

During the DRE

The procedure usually requires the person to undress from the waist down.

The specialist may instruct the person to lie on their left side and pull their knees up to their chest or to stand and lean against a table.

The specialist will:

• put on some gloves and put lubricant on one finger
• assess the area around the rectum for anything unusual
• gently insert a lubricated, gloved finger into the rectum
• feel the prostate to assess the size and check for bumps, soft or hard spots, and other abnormalities

A DRE is not usually painful, but it may be slightly uncomfortable. It takes only a few minutes to complete.

After the DRE

After the exam, the doctor will explain the results.

The person can usually go back to their regular activities immediately after a DRE.

However, there may be some bleeding from the rectum afterward, particularly if the person has hemorrhoids or anal fissures. If bleeding persists or is significant, the person should contact their healthcare provider.

DRE results

The doctor will usually explain the results of the DRE after the exam.

The person may also undergo a PSA test on the same day. If the doctor believes that further steps may be necessary, they will base this on the results of both the PSA and DRE.

It is worth noting that a DRE often produces a false-positive result. If the doctor detects changes in the prostate gland, this does not necessarily indicate cancer.

Prostate nodules can develop because of prostate cancer or other prostate-related conditions. Learn more about prostate nodules here.

This blood test measures the amount of PSA that the prostate gland produces. Some of this antigen leaks into the blood and will show up during testing.

High levels of PSA in the blood can indicate prostate cancer, but various other conditions and factors can raise PSA levels. High levels do not necessarily mean that cancer is present.

What does the PSA test involve?

The PSA test involves taking a blood sample and sending it to a laboratory for analysis. The results indicate:

Normal levels: Most healthy adult males have PSA levels below 4 nanograms per milliliter (ng/ml).

Borderline levels: PSA levels of 4–10 ng/ml are borderline. There is a 1 in 4 chance that cancer is present.

High levels: If PSA levels are over 10 ng/ml, there is a 50% chance that the person has prostate cancer. The specialist will likely recommend more testing, including a prostate biopsy.

It is important to note that PSA levels can naturally vary from person to person. A person with high levels may not have prostate cancer. On the other hand, about 15% of people who test positive for prostate cancer after a biopsy have PSA levels below 4 ng/ml.

Prostate cancer is not the only cause of high PSA levels. Find out more about the other causes here.

What do the results mean?

PSA levels may be above the baseline for various reasons other than prostate cancer.

Other factors that can raise PSA levels include:

• older age
• recent ejaculation
• medical procedures, including a DRE, a biopsy, or some urological investigations
• testosterone supplementation
• an enlarged prostate — because of benign prostatic hyperplasia (BPH), for example
• prostatitis, which is inflammation and swelling of the prostate

Also, people with obesity may have lower PSA readings.

In addition, some medications may reduce PSA levels, including:

• 5-alpha reductase inhibitors, which can help treat BPH
• aspirin, which some people take regularly as a blood thinner
• statins, which help manage cholesterol levels
• thiazide diuretics, a kind of water pill that can help reduce high blood pressure

Some herbal medicines and supplements can also lower PSA levels. Tell the doctor about any medications and supplements before undergoing the test.

High PSA levels alone do not indicate cancer. However, if a DRE also reveals changes, a doctor may recommend a biopsy for a more accurate result.

The PCA3 is another test for prostate cancer that doctors use in some circumstances. Find out more.

What happens next?

If the DRE and PSA tests show nothing unusual, the healthcare provider may recommend monitoring by repeating one or both tests every 1–2 years.

If the results could indicate prostate cancer, the doctor may recommend a biopsy.

A prostate biopsy can lead to complications. What are the alternatives?

There are no official guidelines about screening for prostate cancer, but the ACS recommend talking to a doctor about screening from the following ages:

• 50 years for males with an average risk and a life expectancy of more than 10 years
• 45 years for those with a high risk
• 40 years for people with more than one close relative who developed prostate cancer at an early age

People who have a high risk include African Americans, people with obesity, and anyone with a close relative who received a diagnosis of prostate cancer before age 65.

Not everyone recommends routine screening, however.

In 2018, the U.S. Preventive Services Task Force recommended that the decision to undergo screening from the ages of 55–69 years should be up to the individual. This is because screening can produce false positive results, leading to investigations or surgery that may not be necessary.

Before going ahead with screening, a person should discuss the risks and benefits with their doctor.

According to the National Cancer Institute, Medicare will cover a yearly PSA test for people 50 and over who are eligible for Medicare.

Does frequent ejaculation lower the risk of prostate cancer? Find out here.

Prostate cancer is common. However, if a doctor diagnoses the cancer while it remains in the prostate or nearby and the person receives treatment, it is almost 100% likely that they will survive for at least another 5 years.

If the cancer spreads to other parts of the body, this survival rate falls to 30%.

A person should start asking about the benefits of screening from age 50, or earlier, if they have a higher risk of prostate cancer.

How is it done and who should have one?

Prostate cancer is the second leading cause of cancer among adult males in the United States, after skin cancer. However, it is highly treatable, especially in the early stages.

Prostate cancer starts in the prostate gland, which is part of the male reproductive system. The gland produces a fluid that, together with sperm from the testicles, makes up semen. Muscle cells inside the prostate play a role in ejaculation.

The American Cancer Society (ACS) expect that there will be 174,650 new prostate cancer diagnoses in the U.S. in 2019 and that around 31,620 people in the country will die from this type of cancer during the year.

The ACS also note that 1 in 9 men will receive a diagnosis of prostate cancer during their lifetimes, and around 1 in 41 men will die from the disease. With treatment, there is a good chance of surviving prostate cancer.

Prostate cancer often produces no symptoms in the early stages. After a certain age, the doctor may recommend regular screening. A prostate exam can help detect cancer while it is still highly treatable, even if symptoms are not present.

Share on PinterestA doctor can advise on the main methods of screening for prostate cancer.

Screening involves looking for early signs of a disease in people who do not have any symptoms. Cancer screening aims to detect telltale changes at an early stage, when treatment is more likely to be effective.

Doctors commonly use two main tests to screen for prostate cancer:

• the digital rectal exam (DRE)
• the prostate-specific antigen (PSA) test

Neither test can confirm that prostate cancer is present, as various other factors may influence results. However, these tests can indicate whether further steps are necessary.

A prostate biopsy is the only way to confirm that a person has prostate cancer.

Before undergoing either of these tests, the person will need to give consent, which involves confirming that they understand the potential benefits and risks.

The DRE is a physical examination for changes in the prostate that could indicate a tumor.

Before the DRE

Common questions to ask before a DRE include:

• What will happen during the DRE?
• How long will it take?
• Will it be painful?
• How accurate is a DRE, in terms of finding cancer?
• What will happen next?

The individual should also:

Inform their healthcare team if they have hemorrhoids or anal fissures, as a DRE may exacerbate these.

Ask their insurance provider about coverage and whether there will be additional costs.

During the DRE

The procedure usually requires the person to undress from the waist down.

The specialist may instruct the person to lie on their left side and pull their knees up to their chest or to stand and lean against a table.

The specialist will:

• put on some gloves and put lubricant on one finger
• assess the area around the rectum for anything unusual
• gently insert a lubricated, gloved finger into the rectum
• feel the prostate to assess the size and check for bumps, soft or hard spots, and other abnormalities

A DRE is not usually painful, but it may be slightly uncomfortable. It takes only a few minutes to complete.

After the DRE

After the exam, the doctor will explain the results.

The person can usually go back to their regular activities immediately after a DRE.

However, there may be some bleeding from the rectum afterward, particularly if the person has hemorrhoids or anal fissures. If bleeding persists or is significant, the person should contact their healthcare provider.

DRE results

The doctor will usually explain the results of the DRE after the exam.

The person may also undergo a PSA test on the same day. If the doctor believes that further steps may be necessary, they will base this on the results of both the PSA and DRE.

It is worth noting that a DRE often produces a false-positive result. If the doctor detects changes in the prostate gland, this does not necessarily indicate cancer.

Prostate nodules can develop because of prostate cancer or other prostate-related conditions. Learn more about prostate nodules here.

This blood test measures the amount of PSA that the prostate gland produces. Some of this antigen leaks into the blood and will show up during testing.

High levels of PSA in the blood can indicate prostate cancer, but various other conditions and factors can raise PSA levels. High levels do not necessarily mean that cancer is present.

What does the PSA test involve?

The PSA test involves taking a blood sample and sending it to a laboratory for analysis. The results indicate:

Normal levels: Most healthy adult males have PSA levels below 4 nanograms per milliliter (ng/ml).

Borderline levels: PSA levels of 4–10 ng/ml are borderline. There is a 1 in 4 chance that cancer is present.

High levels: If PSA levels are over 10 ng/ml, there is a 50% chance that the person has prostate cancer. The specialist will likely recommend more testing, including a prostate biopsy.

It is important to note that PSA levels can naturally vary from person to person. A person with high levels may not have prostate cancer. On the other hand, about 15% of people who test positive for prostate cancer after a biopsy have PSA levels below 4 ng/ml.

Prostate cancer is not the only cause of high PSA levels. Find out more about the other causes here.

What do the results mean?

PSA levels may be above the baseline for various reasons other than prostate cancer.

Other factors that can raise PSA levels include:

• older age
• recent ejaculation
• medical procedures, including a DRE, a biopsy, or some urological investigations
• testosterone supplementation
• an enlarged prostate — because of benign prostatic hyperplasia (BPH), for example
• prostatitis, which is inflammation and swelling of the prostate

Also, people with obesity may have lower PSA readings.

In addition, some medications may reduce PSA levels, including:

• 5-alpha reductase inhibitors, which can help treat BPH
• aspirin, which some people take regularly as a blood thinner
• statins, which help manage cholesterol levels
• thiazide diuretics, a kind of water pill that can help reduce high blood pressure

Some herbal medicines and supplements can also lower PSA levels. Tell the doctor about any medications and supplements before undergoing the test.

High PSA levels alone do not indicate cancer. However, if a DRE also reveals changes, a doctor may recommend a biopsy for a more accurate result.

The PCA3 is another test for prostate cancer that doctors use in some circumstances. Find out more.

What happens next?

If the DRE and PSA tests show nothing unusual, the healthcare provider may recommend monitoring by repeating one or both tests every 1–2 years.

If the results could indicate prostate cancer, the doctor may recommend a biopsy.

A prostate biopsy can lead to complications. What are the alternatives?

There are no official guidelines about screening for prostate cancer, but the ACS recommend talking to a doctor about screening from the following ages:

• 50 years for males with an average risk and a life expectancy of more than 10 years
• 45 years for those with a high risk
• 40 years for people with more than one close relative who developed prostate cancer at an early age

People who have a high risk include African Americans, people with obesity, and anyone with a close relative who received a diagnosis of prostate cancer before age 65.

Not everyone recommends routine screening, however.

In 2018, the U.S. Preventive Services Task Force recommended that the decision to undergo screening from the ages of 55–69 years should be up to the individual. This is because screening can produce false positive results, leading to investigations or surgery that may not be necessary.

Before going ahead with screening, a person should discuss the risks and benefits with their doctor.

According to the National Cancer Institute, Medicare will cover a yearly PSA test for people 50 and over who are eligible for Medicare.

Does frequent ejaculation lower the risk of prostate cancer? Find out here.

Prostate cancer is common. However, if a doctor diagnoses the cancer while it remains in the prostate or nearby and the person receives treatment, it is almost 100% likely that they will survive for at least another 5 years.

If the cancer spreads to other parts of the body, this survival rate falls to 30%.

A person should start asking about the benefits of screening from age 50, or earlier, if they have a higher risk of prostate cancer.

5 Things Men Should Know About A Prostate Exam

According to the American Cancer Society, an estimated one in nine men will be diagnosed with prostate cancer. Though it is the second leading cause of cancer death among American men, preventative screenings like a prostate exam can help catch the disease before it becomes fatal.

Matthew Sand, M.D., a urologist at Piedmont, answers five questions men commonly ask about prostate exams.

1.What is a prostate exam?

“A prostate exam is a digital or finger exam in the rectum to feel the prostate through the rectal wall,” says Dr. Sand. “We estimate the size of the prostate and then we feel around for nodules, which are concerning for prostate cancer.”

Prostate exams can be performed along with a prostate-specific antigen (PSA) blood test, which measures the amount of PSA made by the prostate gland. The higher the PSA level, the higher the likelihood that there is a problem with the prostate gland.

“Occasionally you’ll have prostate cancers that don’t make a high PSA,” says Dr. Sand. “But when we perform the rectal exam, we can detect if there is a lump or a nodule in the prostate. So, it’s very important to do the PSA blood test in combination with the rectal exam.”

2. Who should get a prostate exam?

Men over the age of 50 should have an annual prostate exam, says Dr. Sand. If you have a family history of the disease, the exam can be performed as early as age 40.

3. What happens during the prostate exam?

“The exam is fairly straightforward,” says Dr. Sand. “Patients bend over the exam table positioning their elbows on the table. Wearing a lubricated glove, the doctor inserts his index finger into the rectum. We then palpitate the prostate from side-to-side a couple of times, taking a feel for nodules, bumps, lumps or a hard spot. Then we estimate the size of the prostate gland.”

4. Does a prostate exam hurt?

“The whole procedure probably takes three to five seconds,” says Dr. Sand. “A little short-term discomfort can save you a lot of long-term pain and suffering.”

5. Why is it important to get a prostate screening?

Men aren’t great healthcare-seekers on their own, says Dr. Sand.

“They usually go to the doctor for lifestyle issues like erectile dysfunction or urinary issues, but often delay screening testing,” he says.

Prostate cancer is asymptomatic, which means men usually don’t show signs or symptoms of the disease until it’s in a more advanced stage.

“A screening is the only way to catch prostate cancer in the early stages,” says Dr. Sand. “If caught early, it’s very treatable and the survival rate is excellent. If you don’t screen and take care of it, the outcomes are much worse.”

Find a urologist near you so you can schedule a prostate cancer screening. The exam only takes a few minutes and it could save your life.

Need to make an appointment with a Piedmont physician? Save time, book online.

If Prostate Cancer Screening Test Aren’t Normal

Screening is testing to find cancer in people before they have symptoms.
It’s not clear, however, if the benefits of prostate cancer screening outweigh the risks for most men. Still, after discussing the pros and cons of screening with their doctors, some men might reasonably choose to be screened.

The screening tests discussed here are used to look for possible signs of prostate cancer. But these tests can’t tell for sure if you have cancer. If the result of one of these tests is abnormal, you will probably need a prostate biopsy (discussed below) to know for sure if you have cancer.

Prostate-specific antigen (PSA) blood test

Prostate-specific antigen (PSA) is a protein made by cells in the prostate gland (both normal cells and cancer cells). PSA is mostly found in semen, but a small amount is also found in blood.

The PSA level in blood is measured in units called nanograms per milliliter (ng/mL). The chance of having prostate cancer goes up as the PSA level goes up, but there is no set cutoff point that can tell for sure if a man does or doesn’t have prostate cancer. Many doctors use a PSA cutoff point of 4 ng/mL or higher when deciding if a man might need further testing, while others might recommend it starting at a lower level, such as 2.5 or 3. 

• Most men without prostate cancer have PSA levels under 4 ng/mL of blood. When prostate cancer develops, the PSA level often goes above 4. Still, a level below 4 is not a guarantee that a man doesn’t have cancer. About 15% of men with a PSA below 4 will have prostate cancer if a biopsy is done.
• Men with a PSA level between 4 and 10 (often called the “borderline range”) have about a 1 in 4 chance of having prostate cancer. 
• If the PSA is more than 10, the chance of having prostate cancer is over 50%.
  

If your PSA level is high, you might need further tests to look for prostate cancer (see ‘If screening tests results aren’t normal’, below).

Factors that might affect PSA levels

One reason it’s hard to use a set cutoff point with the PSA test when looking for prostate cancer is that a number of factors other than cancer can also affect PSA levels.

Factors that might raise PSA levels include:

• An enlarged prostate: Conditions such as benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate that affects many men as they grow older, can raise PSA levels.
• Older age: PSA levels normally go up slowly as you get older, even if you have no prostate abnormality.
• Prostatitis: This is an infection or inflammation of the prostate gland, which can raise PSA levels.
• Ejaculation: This can make the PSA go up for a short time. This is why some doctors suggest that men abstain from ejaculation for a day or two before testing.
• Riding a bicycle: Some studies have suggested that cycling may raise PSA levels for a short time (possibly because the seat puts pressure on the prostate), although not all studies have found this.
• Certain urologic procedures: Some procedures done in a doctor’s office that affect the prostate, such as a prostate biopsy or cystoscopy, can raise PSA levels for a short time. Some studies have suggested that a digital rectal exam (DRE) might raise PSA levels slightly, although other studies have not found this. Still, if both a PSA test and a DRE are being done during a doctor visit, some doctors advise having the blood drawn for the PSA before having the DRE, just in case.
• Certain medicines: Taking male hormones like testosterone (or other medicines that raise testosterone levels) may cause a rise in PSA.

Some things might lower PSA levels (even if a man has prostate cancer):

• 5-alpha reductase inhibitors: Certain drugs used to treat BPH or urinary symptoms, such as finasteride (Proscar or Propecia) or dutasteride (Avodart), can lower PSA levels. These drugs can also affect prostate cancer risk (discussed in Can Prostate Cancer Be Prevented?). Tell your doctor if you are taking one of these medicines. Because they can lower PSA levels, the doctor might need to adjust for this.
• Herbal mixtures: Some mixtures that are sold as dietary supplements might mask a high PSA level. This is why it’s important to let your doctor know if you are taking any type of supplement, even ones that are not necessarily meant for prostate health. Saw palmetto (an herb used by some men to treat BPH) does not seem to affect PSA.
• Certain other medicines: Some research has suggested that long-term use of certain medicines, such as aspirin, statins (cholesterol-lowering drugs), and thiazide diuretics (such as hydrochlorothiazide) might lower PSA levels. More research is needed to confirm these findings. If you take any of the medicines regularly, talk to your doctor before you stop taking it for any reason.

For men who might be screened for prostate cancer, it’s not always clear if lowering the PSA is helpful. In some cases the factor that lowers the PSA may also lower a man’s risk of prostate cancer. But in other cases, it might lower the PSA level without affecting a man’s risk of cancer. This could actually be harmful, if it were to lower the PSA from an abnormal level to a normal one, as it might result in not detecting a cancer. This is why it’s important to talk to your doctor about anything that might affect your PSA level.

Special types of PSA tests

The PSA level from a screening test is sometimes referred to as total PSA, because it includes the different forms of PSA (described below). If you decide to get a PSA screening test and the result isn’t normal, some doctors might consider using different types of PSA tests to help decide if you need a prostate biopsy, although not all doctors agree on how to use these tests. If your PSA test result isn’t normal, ask your doctor to discuss your cancer risk and your need for further tests.

Percent-free PSA: PSA occurs in 2 major forms in the blood. One form is attached to blood proteins, while the other circulates free (unattached). The percent-free PSA (%fPSA) is the ratio of how much PSA circulates free compared to the total PSA level. The percentage of free PSA is lower in men who have prostate cancer than in men who do not.

If your PSA test result is in the borderline range (between 4 and 10), the percent-free PSA might be used to help decide if you should have a prostate biopsy. A lower percent-free PSA means that your chance of having prostate cancer is higher and you should probably have a biopsy.

Many doctors recommend a prostate biopsy for men whose percent-free PSA is 10% or less, and advise that men consider a biopsy if it is between 10% and 25%. Using these cutoffs detects most cancers and helps some men avoid unnecessary biopsies. This test is widely used, but not all doctors agree that 25% is the best cutoff point to decide on a biopsy, and the cutoff may change depending on the overall PSA level.

Complexed PSA: This test directly measures the amount of PSA that is attached to other proteins (the portion of PSA that is not “free”). This test could be done instead of checking the total and free PSA, and it could give the same amount of information, but it is not widely used.

Tests that combine different types of PSA: Some newer tests combine the results of different types of PSA to get an overall score that reflects the chance a man has prostate cancer (particularly cancer that might need treatment).These tests include:

• The Prostate Health Index (PHI), which combines the results of total PSA, free PSA, and proPSA

• The 4Kscore test, which combines the results of total PSA, free PSA, intact PSA, and human kallikrein 2 (hK2), along with some other factors

These tests might be useful in men with a slightly elevated PSA, to help determine if they should have a prostate biopsy. These tests might also be used to help determine if a man who has already had a prostate biopsy that didn’t find cancer should have another biopsy.

PSA velocity: The PSA velocity is not a separate test. It is a measure of how fast the PSA rises over time. Normally, PSA levels go up slowly with age. Some research has found that these levels go up faster if a man has cancer, but studies have not shown that the PSA velocity is more helpful than the PSA level itself in finding prostate cancer. For this reason, the ACS guidelines do not recommend using the PSA velocity as part of screening for prostate cancer.

PSA density: PSA levels are higher in men with larger prostate glands. The PSA density (PSAD) is sometimes used for men with large prostate glands to try to adjust for this. The doctor measures the volume (size) of the prostate gland with transrectal ultrasound (discussed in Tests to Diagnose and Stage Prostate Cancer) and divides the PSA number by the prostate volume. A higher PSA density indicates a greater likelihood of cancer. PSA density has not been shown to be as useful as the percent-free PSA test.

Age-specific PSA ranges: PSA levels are normally higher in older men than in younger men, even when there is no cancer. A PSA result within the borderline range might be worrisome in a 50-year-old man but cause less concern in an 80-year-old man. For this reason, some doctors have suggested comparing PSA results with results from other men of the same age.

But the usefulness of age-specific PSA ranges is not well proven, so most doctors and professional organizations (as well as the makers of the PSA tests) do not recommend their use at this time.

Digital rectal exam (DRE)

For a digital rectal exam (DRE), the doctor inserts a gloved, lubricated finger into the rectum to feel for any bumps or hard areas on the prostate that might be cancer. As shown in the picture below, the prostate is just in front of the rectum. Prostate cancers often begin in the back part of the gland, and can sometimes be felt during a rectal exam. This exam can be uncomfortable (especially for men who have hemorrhoids), but it usually isn’t painful and only takes a short time.

DRE is less effective than the PSA blood test in finding prostate cancer, but it can sometimes find cancers in men with normal PSA levels. For this reason, it might be included as a part of prostate cancer screening.

If you are screened for prostate cancer and your initial blood PSA level is higher than normal, it doesn’t always mean that you have prostate cancer. Many men with higher than normal PSA levels do not have cancer. Still, further testing will be needed to help find out what is going on. Your doctor may advise one of these options:

It’s important to discuss your options, including their possible pros and cons, with your doctor to help you choose one you are comfortable with. Factors that might affect which option is best for you include: 

If your initial PSA test was ordered by your primary care provider, you may be referred to a urologist (a doctor who treats cancers of the genital and urinary tract, which includes the prostate gland) for this discussion or for further testing.

A man’s blood PSA level can vary over time (for a number of reasons), so some doctors recommend repeating the test after a month or so if the initial PSA result is abnormal. This is most likely to be a reasonable option if the PSA level is on the lower end of the borderline range (typically 4 to 7 ng/mL).
For higher PSA levels, doctors are more likely to recommend getting other tests, or going straight to a prostate biopsy.

If the initial PSA result is abnormal, another option might be to get another type of test (or tests) to help you and your doctor get a better idea if you might have prostate cancer (and therefore need a biopsy). Some of the tests that might be done include:

(If the initial abnormal test was a DRE, the next step is typically to get a PSA blood test (and possibly other tests, such as a TRUS).)

For some men, getting a prostate biopsy might be the best option, especially if the initial PSA level is high. A biopsy is a procedure in which small samples of the prostate are removed and then looked at under a microscope. This test is the only way to know for sure if a man has prostate cancer. If prostate cancer is found on a biopsy, this test can also help tell how likely it is that the cancer will grow and spread quickly. 

For more information about the possible results of a prostate biopsy, see the Prostate Pathology section of our website.

Tests for Prostate Cancer | Prostate Cancer Diagnosis

Most prostate cancers are first found as a result of screening.
(See Screening Tests for Prostate Cancer.) Early prostate cancers usually don’t cause symptoms, but more advanced cancers are sometimes first found because of symptoms they cause.

If prostate cancer is suspected based on results of screening tests or symptoms, tests will be needed to be sure. If you’re seeing your primary care doctor, you might be referred to a urologist, a doctor who treats cancers of the genital and urinary tract, including the prostate.

The actual diagnosis of prostate cancer can only be made with a prostate biopsy (discussed below).

Medical history and physical exam

If your doctor suspects you might have prostate cancer, he or she will ask you about any symptoms you are having, such as any urinary or sexual problems, and how long you have had them. You might also be asked about possible risk factors, including your family history.

Your doctor will also examine you. This might include a digital rectal exam (DRE), during which the doctor inserts a gloved, lubricated finger into your rectum to feel for any bumps or hard areas on the prostate that might be cancer. If you do have cancer, the DRE can sometimes help tell if it’s only on one side of the prostate, if it’s on both sides, or if it’s likely to have spread beyond the prostate to nearby tissues. Your doctor may also examine other areas of your body.

After the exam, your doctor might then order some tests.

PSA blood test

Prostate-specific antigen (PSA) is a protein made by cells in the prostate gland (both normal cells and cancer cells). PSA is mostly in semen, but a small amount is also in the blood. 

Use in men who might have prostate cancer

The PSA blood test is used mainly to screen for prostate cancer in men without symptoms. It’s also one of the first tests done in men who have symptoms that might be caused by prostate cancer.

PSA in the blood is measured in units called nanograms per milliliter (ng/mL). The chance of having prostate cancer goes up as the PSA level goes up, but there is no set cutoff point that can tell for sure if a man does or doesn’t have prostate cancer. Many doctors use a PSA cutoff point of 4 ng/mL or higher when deciding if a man might need further testing, while others might recommend it starting at a lower level, such as 2.5 or 3. 

• Most men without prostate cancer have PSA levels under 4 ng/mL of blood. Still, a level below 4 is not a guarantee that a man doesn’t have cancer.
• Men with a PSA level between 4 and 10 (often called the “borderline range”) have about a 1 in 4 chance of having prostate cancer. 
• If the PSA is more than 10, the chance of having prostate cancer is over 50%.
  

If your PSA level is high, you might need further tests to look for prostate cancer. 

To learn more about how the PSA test is used to look for cancer, including factors that can affect PSA levels, special types of PSA tests, and what the next steps might be if you have an abnormal PSA level, see Screening Tests for Prostate Cancer.

Use in men already diagnosed with prostate cancer

The PSA test can also be useful if you have already been diagnosed with prostate cancer.

• In men just diagnosed with prostate cancer, the PSA level can be used together with physical exam results and tumor grade (determined on the biopsy, described further on) to help decide if other tests (such as CT scans or bone scans) are needed.
• The PSA level is used to help determine the stage of your cancer. This can affect your treatment options, since some treatments (such as surgery and radiation) are not likely to be helpful if the cancer has spread to other parts of the body.
• PSA tests are often an important part of determining how well treatment is working, as well as in watching for a possible recurrence of the cancer after treatment (see Following PSA Levels During and After Treatment).

Prostate biopsy

If the results of a PSA blood test, DRE, or other tests suggest that you might have prostate cancer, you will most likely need a prostate biopsy.

A biopsy is a procedure in which small samples of the prostate are removed and then looked at with a microscope. A core needle biopsy is the main method used to diagnose prostate cancer. It is usually done by a urologist.

During the biopsy, the doctor usually looks at the prostate with an imaging test such as transrectal ultrasound (TRUS) or MRI, or a ‘fusion’ of the two (all discussed below). The doctor quickly inserts a thin, hollow needle into the prostate. This is done either through the wall of the rectum (a transrectal biopsy) or through the skin between the scrotum and anus (a transperineal biopsy). When the needle is pulled out it removes a small cylinder (core) of prostate tissue. This is repeated several times. Most often the doctor will take about 12 core samples from different parts of the prostate.

Though the procedure sounds painful, each biopsy usually causes only some brief discomfort because it is done with a special spring-loaded biopsy instrument. The device inserts and removes the needle in a fraction of a second. Most doctors who do the biopsy will numb the area first by injecting a local anesthetic alongside the prostate. You might want to ask your doctor if he or she plans to do this.

The biopsy itself takes about 10 minutes and is usually done in the doctor’s office. You will likely be given antibiotics to take before the biopsy and possibly for a day or 2 after to reduce the risk of infection.

For a few days after the procedure, you may feel some soreness in the area and might notice blood in your urine. You may also have some light bleeding from your rectum, especially if you have hemorrhoids. Many men notice blood in their semen or have rust colored semen, which can last for several weeks after the biopsy, depending on how often you ejaculate.

Getting the results of the biopsy

Your biopsy samples will be sent to a lab, where they will be looked at with a microscope to see if they contain cancer cells. Getting the results (in the form of a pathology report) usually takes at least 1 to 3 days, but it can sometimes take longer. The results might be reported as:

• Positive for cancer: Cancer cells were seen in the biopsy samples.
• Negative for cancer: No cancer cells were seen in the biopsy samples.
• Suspicious: Something abnormal was seen, but it might not be cancer. (Different types of suspicious results are discussed below.)

If the biopsy is negative

If the prostate biopsy results are negative (that is, if they don’t show cancer), and the chance that you have prostate cancer isn’t very high based on your PSA level and other tests, you might not need any more tests, other than repeat PSA tests (and possibly DREs) sometime later.

But even if many samples are taken, biopsies can still sometimes miss a cancer if none of the biopsy needles pass through it. This is known as a false-negative result. If your doctor still strongly suspects you have prostate cancer (because your PSA level is very high, for example), your doctor might suggest:

• Getting other lab tests (of blood, urine, or the prostate biopsy samples) to help get a better idea of whether or not you might have prostate cancer. Examples of such tests include the Prostate Health Index (PHI), 4Kscore test, PCA3 tests (such as Progensa), and ConfirmMDx. These tests are discussed in What’s New in Prostate Cancer Research?
• Getting a repeat prostate biopsy. This might include getting additional samples of parts of the prostate not biopsied the first time, or using imaging tests such as MRI (described below) to look more closely for abnormal areas to target.

Prostate cancer grade (Gleason score or Grade Group)

If prostate cancer is found on a biopsy, it will be assigned a grade. The grade of the cancer is based on how abnormal the cancer looks under the microscope. Higher grade cancers look more abnormal, and are more likely to grow and spread quickly. There are 2 main ways to describe the grade of a prostate cancer.

Gleason score

The Gleason system, which has been in use for many years, assigns grades based on how much the cancer looks like normal prostate tissue.

• If the cancer looks a lot like normal prostate tissue, a grade of 1 is assigned.
• If the cancer looks very abnormal, it is given a grade of 5.
• Grades 2 through 4 have features in between these extremes.

Almost all cancers are grade 3 or higher; grades 1 and 2 are not often used.

Since prostate cancers often have areas with different grades, a grade is assigned to the 2 areas that make up most of the cancer. These 2 grades are added to yield the Gleason score (also called the Gleason sum).

The first number assigned is the grade that is most common in the tumor. For example, if the Gleason score is written as 3+4=7, it means most of the tumor is grade 3 and less is grade 4, and they are added for a Gleason score of 7.

Although most often the Gleason score is based on the 2 areas that make up most of the cancer, there are some exceptions when a biopsy sample has either a lot of high-grade cancer or there are 3 grades including high-grade cancer. In these cases, the way the Gleason score is determined is modified to reflect the aggressive (fast-growing) nature of the cancer.

In theory, the Gleason score can be between 2 and 10, but scores below 6 are rarely used.

Based on the Gleason score, prostate cancers are often divided into 3 groups:

• Cancers with a Gleason score of 6 or less may be called well-differentiated or low-grade.
• Cancers with a Gleason score of 7 may be called moderately-differentiated or intermediate-grade.
• Cancers with Gleason scores of 8 to 10 may be called poorly-differentiated or high-grade.

Grade Groups

In recent years, doctors have come to realize that the Gleason score might not always be the best way to describe the grade of the cancer, for a couple of reasons:

• Prostate cancer outcomes can be divided into more than just the 3 groups mentioned above. For example, men with a Gleason score 3+4=7 cancer tend to do better than those with a 4+3=7 cancer. And men with a Gleason score 8 cancer tend to do better than those with a Gleason score of 9 or 10.
• The scale of the Gleason score can be misleading for patients. For example, a man with a Gleason score 6 cancer might assume that his cancer is in the middle of the range of grades (which in theory go from 2 to 10), even though grade 6 cancers are actually the lowest grade seen in practice. This assumption might lead a man to think his cancer is more likely to grow and spread quickly than it really is, which might affect his decisions about treatment.

Because of this, doctors have developed Grade Groups, ranging from 1 (most likely to grow and spread slowly) to 5 (most likely to grow and spread quickly):

• Grade Group 1 = Gleason 6 (or less)
• Grade Group 2 = Gleason 3+4=7
• Grade Group 3 = Gleason 4+3=7
• Grade Group 4 = Gleason 8
• Grade Group 5 = Gleason 9-10

The Grade Groups will likely replace the Gleason score over time, but currently you might see either one (or both) on a biopsy pathology report.

Other information in a pathology report

Along with the grade of the cancer (if it is present), the pathology report often contains other information about the cancer, such as:

• The number of biopsy core samples that contain cancer (for example, “7 out of 12”)
• The percentage of cancer in each of the cores
• Whether the cancer is on one side (left or right) of the prostate or on both sides (bilateral)

Suspicious results

Sometimes when the prostate cells are seen, they don’t look like cancer, but they’re not quite normal, either.

Prostatic intraepithelial neoplasia (PIN): In PIN, there are changes in how the prostate cells look, but the abnormal cells don’t look like they’ve grown into other parts of the prostate (like cancer cells would). PIN is often divided into 2 groups:

• Low-grade PIN: The patterns of prostate cells appear almost normal.
• High-grade PIN: The patterns of cells look more abnormal.

Many men begin to develop low-grade PIN at an early age, but low-grade PIN is not thought to be related to prostate cancer risk. If low-grade PIN is reported on a prostate biopsy, the follow-up for patients is usually the same as if nothing abnormal was seen.

If high-grade PIN is found on a biopsy, there is a greater chance that you might develop prostate cancer over time. This is why doctors often watch men with high-grade PIN carefully and may advise another prostate biopsy (or lab tests to help determine the risk of having cancer, such as the Prostate Health Index (PHI), 4Kscore test, PCA3 tests (such as Progensa), or ConfirmMDx). This is especially true if high-grade PIN is found in different parts of the prostate (multifocal high-grade PIN), or if the original biopsy did not take samples from all parts of the prostate.

Atypical small acinar proliferation (ASAP): This might also be called glandular atypia or atypical glandular proliferation. It might also just be reported as “suspicious for cancer.” All of these terms mean that the cells look like they might be cancer when seen with the microscope, but there are too few of them to be sure. If one of these terms is used, there’s a high chance that there is also cancer in the prostate, which is why many doctors recommend repeating the biopsy within a few months.

Proliferative inflammatory atrophy (PIA): In PIA, the prostate cells look smaller than normal, and there are signs of inflammation in the area. PIA is not cancer, but researchers believe that PIA may sometimes lead to high-grade PIN or to prostate cancer directly.

For more information about how prostate biopsy results are reported, see the Prostate Pathology section of our website.

Genetic testing for some men with prostate cancer

Some doctors
now recommend that some men with prostate cancer be tested to look for certain inherited gene changes. This includes men in whom a family cancer syndrome (such as a BRCA gene mutation or Lynch syndrome) is suspected, as well as men with prostate cancer that has certain high-risk features or that has spread to other parts of the body. Talk to your doctor about the possible pros, cons, and limitations of such testing. 

Imaging tests for prostate cancer

Imaging tests use x-rays, magnetic fields, sound waves, or radioactive substances to create pictures of the inside of your body. One or more imaging tests might be used:

• To look for cancer in the prostate
• To help the doctor see the prostate during certain procedures (such as a prostate biopsy or certain types of prostate cancer treatment)
• To look for spread of prostate cancer to other parts of the body

Which tests you might need will depend on the situation. For example, a prostate biopsy is typically done with transrectal ultrasound (TRUS) and/or MRI to help guide the biopsy. If you are found to have prostate cancer, you might need imaging tests of other parts of your body to look for possible cancer spread. (Men with a normal DRE result, a low PSA, and a low Gleason score may not need any other tests because the chance that the cancer has spread is so low.)

The imaging tests used most often to look for prostate cancer spread include:

Transrectal ultrasound (TRUS)

For this test, a small probe about the width of a finger is lubricated and placed in your rectum. The probe gives off sound waves that enter the prostate and create echoes. The probe picks up the echoes, and a computer turns them into a black and white image of the prostate.

The procedure often takes less than 10 minutes and is done in a doctor’s office or outpatient clinic. You will feel some pressure when the probe is inserted, but it is usually not painful. The area may be numbed before the procedure.

TRUS might be used in different situations: 

• It is sometimes used to look for suspicious areas in the prostate in men who have an abnormal DRE or PSA test result (although it can miss some cancers). 
• It can be used during a prostate biopsy to guide the needles into the correct area of the prostate.
• It can be used to measure the size of the prostate gland, which can help determine the PSA density (described in Screening Tests for Prostate Cancer). 
• It can be used as a guide during some forms of treatment such as brachytherapy (internal radiation therapy) or cryotherapy.

Newer forms of TRUS, such as color Doppler ultrasound, might be even more helpful in some situations. (See What’s New in Prostate Cancer Research?)

Magnetic resonance imaging (MRI)

MRI scans create detailed images of soft tissues in the body using radio waves and strong magnets. MRI scans can give doctors a very clear picture of the prostate and nearby areas. A contrast material called gadolinium may be injected into a vein before the scan to better see details.

MRI might be used in different situations:

• It can be used to help determine if a man with an abnormal screening test or with symptoms that might be from prostate cancer should get a prostate biopsy. (The type of MRI often used for this, known as multiparametric MRI, is described below.)
• If a prostate biopsy is planned, an MRI might be done to help locate and target areas of the prostate that are most likely to contain cancer. This is often done as an MRI/ultrasound fusion biopsy, which is described below.
• MRI can be used during a prostate biopsy to help guide the needles into the prostate.
• If prostate cancer has been found, MRI can be done to help determine the extent (stage) of the cancer. MRI scans can show if the cancer has spread outside the prostate into the seminal vesicles or other nearby structures. This can be very important in determining your treatment options. But MRI scans aren’t usually needed for newly diagnosed prostate cancers that are likely to be confined to the prostate based on other factors.

To improve the accuracy of the MRI, you might have a probe, called an endorectal coil, placed inside your rectum for the scan. This can be uncomfortable for some men. If needed, you can be given medicine to make you feel sleepy (sedation).

Multiparametric MRI: This newer MRI technique can be used to help better define possible areas of cancer in the prostate, as well as to get an idea of how quickly a cancer might grow. It can also help show if the cancer has grown outside the prostate or spread to other parts of the body. For this test, a standard MRI is done to look at the anatomy of the prostate, and then at least one other type of MRI (such as diffusion weighted imaging [DWI], dynamic contrast enhanced [DCE] MRI, or MR spectroscopy) is done to look at other parameters of the prostate tissue. The results of the different scans are then compared to help find abnormal areas.

When this test is done to help determine if a man might have prostate cancer, the results are typically reported using the Prostate Imaging Reporting and Data System, or PI-RADS. In this system, abnormal areas in the prostate are assigned a category on a scale ranging from PI-RADS 1 (very unlikely to be a clinically significant cancer) to PI-RADS 5 (very likely to be a clinically significant cancer).

MRI/ultrasound fusion-guided prostate biopsy: In this approach, a man gets an MRI scan a few days or weeks before the biopsy to look for abnormal areas in the prostate. During the biopsy itself, TRUS is used to view to prostate, and a special computer program is used to fuse the MRI and TRUS images on a computer screen. This can help ensure the doctor gets biopsy samples from any suspicious areas seen on the images.

Bone scan

If prostate cancer spreads to distant parts of the body, it often goes to the bones first. A bone scan can help show if cancer has reached the bones.

For this test, you are injected with a small amount of low-level radioactive material, which settles in damaged areas of bone throughout the body. A special camera detects the radioactivity and creates a picture of your skeleton.

A bone scan might suggest cancer in the bone, but to make an accurate diagnosis, other tests such as plain x-rays, CT or MRI scans, or even a bone biopsy might be needed.

Positron emission tomography (PET) scan

A PET scan is similar to a bone scan, in that a slightly radioactive substance (known as a tracer) is injected into the blood, which can then be detected with a special camera. But PET scans use different tracers that collect mainly in cancer cells. The most common tracer for standard PET scans is FDG, which is a type of sugar. Unfortunately, this type of PET scan isn’t very useful in finding prostate cancer cells in the body.

However, newer tracers, such as fluciclovine F18, sodium fluoride F18, and choline C11, have been found to be better at detecting prostate cancer cells.

Other newer tracers, such as Ga 68 PSMA-11 and 18F-DCFPyl, attach to prostate-specific membrane antigen (PSMA), a protein that is often found in large amounts on prostate cancer cells. Tests using these types of tracers are sometimes referred to as PSMA PET scans.

These newer types of PET scans are most often used if it’s not clear if (or exactly where) prostate cancer has spread. For example, one of these tests might be done if the results of a bone scan aren’t clear, or if a man has a rising PSA level after initial treatment but it’s not clear where the cancer is in the body.

The pictures from a PET scan aren’t as detailed as MRI or CT scan images, but they can often show areas of cancer anywhere in the body. Some machines can do a PET scan and either an MRI (PET-MRI) or a CT scan (PET-CT) at the same time, which can give more detail about areas that show up on the PET scan. 

Doctors are still learning about the best ways to use these newer types of PET scans, and some of them might not be available yet in all imaging centers.

Computed tomography (CT) scan

A CT scan uses x-rays to make detailed, cross-sectional images of your body. This test isn’t often needed for newly diagnosed prostate cancer if the cancer is likely to be confined to the prostate based on other findings (DRE result, PSA level, and Gleason score). Still, it can sometimes help tell if prostate cancer has spread into nearby lymph nodes. If your prostate cancer has come back after treatment, the CT scan can often tell if it is growing into other organs or structures in your pelvis.

CT scans are not as useful as magnetic resonance imaging (MRI) for looking at the prostate gland itself.

Lymph node biopsy

In a lymph node biopsy, also known as lymph node dissection or lymphadenectomy, one or more lymph nodes are removed to see if they have cancer cells. This isn’t done very often for prostate cancer, but it might be used to find out if the cancer has spread from the prostate to nearby lymph nodes.

Biopsy during surgery to treat prostate cancer

If there is more than a very small chance
that the cancer might have spread (based on factors such as a high PSA level or a high Gleason score), the surgeon may remove lymph nodes in the pelvis during the same operation as the removal of the prostate, which is known as a radical prostatectomy (see Surgery for Prostate Cancer).

The lymph nodes and the prostate are then sent to the lab to be looked at. The lab results are usually available several days after surgery.

Lymph node biopsy as a separate procedure

A lymph node biopsy is rarely done as a separate procedure. It’s sometimes used when a radical prostatectomy isn’t planned (such as for some men who choose treatment with radiation therapy), but when it’s still important to know if the lymph nodes contain cancer.

Most often, this is done as a needle biopsy. To do this, the doctor uses an image (such as from an MRI or CT scan) to guide a long, hollow needle through the skin in the lower abdomen and into an enlarged node. The skin is numbed with local anesthesia before the needle is inserted to take a small tissue sample. The sample is then sent to the lab and looked at for cancer cells.

90,000 Five Reasons to Check Your Prostate – Articles & Useful Information

The prostate gland is a real “Achilles’ heel” of men’s health. The prostate can begin to bother for various reasons, we have selected the most common causes.

Age

With age, the prostate gland begins to increase in size. Alas, this is inevitable. In varying degrees of progression, this process affects all men. Therefore, after 45, it is worth visiting a urologist at least once a year to understand how your main gland is changing.Such a preventive examination will help to avoid the development of benign hyperplasia – a disease that, according to statistics, occurs in more than half of men over 40-50 years old.

Heredity

If your closest male relatives have encountered cancer related to the prostate, this is a serious reason to be on your guard. Modern medicine makes it possible to accurately assess the possible risks of developing prostate cancer. In particular, the simplest and most accessible method is a prostate specific antigen test or PSA abbreviated test.A blood test will help determine the level of the substance or the norm for your age group.

Sedentary lifestyle

Static work in a seated position and generally sedentary lifestyle negatively affects

for the prostate. Lack of physical activity disrupts the necessary circulation of blood and lymph

in the pelvic area, hence the problems with the gland. There are a number of exercises for

stimulation of the pelvic muscles and, of course, do not forget about regular sex – the best

prophylaxis cannot be invented.

Problems with urination

The prostate is a small organ that sits under the bladder and wraps around the urethra, so the urine stream is a definite indicator of health. If you notice that it goes intermittently or when urinating you have to strongly strain the abdominal muscles and even

experiencing pain is a wake-up call.

Decreased libido

The prostate is actively involved in sexual activity, producing a certain secret that is mixed with sperm during ejaculation.Therefore, any adverse symptoms – weak sexual desire, sluggish erection, as well as rapid ejaculation, are possibly signs of an inflammatory process of the prostate gland.

90,000 Men need to take care of their prostate health

Urologists draw the attention of men to the fact that upon reaching the age of 45, it is necessary at least once a year to come for a prostate examination, which will help diagnose prostate cancer at an early stage and successfully cure it.In no case should you ignore any unpleasant symptoms in the genital area or during urination, as they can warn of a serious problem.

Danute SAVICKAITE

The importance of early diagnosis

Prostate cancer is the most common cancer among men. This disease is diagnosed mainly in men over the age of 50. According to Deimantas Šukis, a urologist at Northway Medical Center, in the early stages, when cancer can still be successfully treated, this cancer does not show any symptoms, so men who have reached 40 years old are advised to have a prostate examination, and those aged 45-50 years should do it is regular to detect prostate tumors in time.

During a preventive check, a blood test is done to determine the level of PSA (prostate specific antigen). From the age of 45-50, men are advised to have this test once a year. In addition to a blood test for PSA, the doctor palpates the prostate. If, after a PSA test or palpation, the doctor suspects the presence of possible lesions, the doctor takes a sample of prostate tissue for a biopsy, which will or may not confirm the diagnosis of a prostate tumor.If a prostate tumor is detected, the doctor selects the necessary treatment, which, as a rule, is highly effective in the initial stages of the disease.

“Prostate cancer, although often diagnosed, most often develops slowly: from the initial stage of the disease to the spread of metastases to other organs, it may take more than one year. If the disease is diagnosed early, then there will be time for its treatment, – says D. Shukis. “In addition, if cancer cells were detected in small numbers, the patient does not need to be operated on, only to actively monitor him.”

After prostate surgery, complications such as worse urination and erectile dysfunction are possible. But, according to the urologist, men should not be afraid of this, because the percentage of complications is very low. Most patients return to normal life after 6-12 months.

An alternative (surgical) treatment for prostate cancer is radiation therapy, which is also a radical treatment. Surgical intervention remains the “gold standard”.because radiation therapy is used in cases where the patient cannot be operated on for one reason or another.

All tests and tests required to diagnose prostate cancer are performed at Northway Medical Center. At the center, you can take a urological examination program, by choosing which men can check their health and save money.

Don’t ignore the symptoms

According to D. Shukis, men who take care of their health should not ignore even the slightest unpleasant symptoms in the pelvic or genital area, i.e.That is, they can indicate not only the presence of prostate cancer, but also any other serious disease.

Often, older men are diagnosed with benign prostatic hyperplasia (prostate gland). It develops when, with age, due to hormonal changes, the proliferation of prostate tissue begins, causing impaired urination. At the initial stage of the disease, the doctor prescribes drug therapy that reduces the symptoms of the disease and stops the proliferation of the prostate, and later, when the drugs stop helping or complications of the disease (for example, urinary retention, bladder stones, chronic infection) are used, surgical treatment is used.

Another common disease is chronic inflammation of the prostate. Men of different ages suffer from this unpleasant disease. Its symptoms include pain, discomfort in the lower abdomen, genitals, and urinary disorders. Chronic prostate inflammation is usually caused by a lack of treatment or inappropriate treatment for the common cold. Chronic inflammation of the prostate is usually treated with antibacterial drugs. The absence of treatment for this disease increases the likelihood of developing prostate cancer, exacerbates the symptoms of benign prostatic hyperplasia.For this reason, men who have urinary disorders or pain in the genital or pelvic area are advised to consult a urologist as soon as possible, undergo an examination and start treatment.

Get an ultrasound of the prostate in Ladozhskaya at a bargain price

Ultrasound of the prostate in the Liteiny medical center near the metro station Ladozhskaya is a mandatory preventive procedure for men interested in maintaining prostate health in order to stay at peak activity longer and vitality.To control the condition of this most important organ, the doctor will definitely recommend to do an ultrasound of the prostate with a repeat after some time.

The prostate is a small gland in the shape of a chestnut and weighing only 30 g performs not one, but three functions – secretory, barrier and motor. Participating in the hormonal metabolism of men, the prostate indirectly affects the functions of almost all organs and systems.

It is not for nothing that the prostate gland is called the second heart of a man.But, unfortunately, it can also become a target of harmful microorganisms that can cause inflammation. If you feel uncomfortable, you should not let everything go by itself. Timely visit to the doctor with the passage of ultrasound of the prostate at st. m. Ladozhskaya in Liteiny will help to avoid the transition of the disease into a chronic form and, possibly, in the future will relieve you of such a problem as prostate adenoma or even its malignant tumor.

Prostate ultrasound can be done in our medical center at the best prices – doctors of the highest category!

It is not for nothing that the prostate gland is called the second heart of a man.Every man is interested in maintaining the health of the prostate in order to stay at the peak of activity and vitality for a longer time. Periodic ultrasound of the prostate will help you monitor the condition of this vital organ.

When and why is it worth to undergo an ultrasound of the prostate.

The prostate is a small chestnut-shaped gland weighing only 30 g performs not one, but three functions – secretory, barrier and motor. Participating in the hormonal metabolism of men, the prostate indirectly affects the functions of almost all organs and systems.

Unfortunately, the prostate gland can also become a target of harmful microorganisms that can cause inflammation. If you feel uncomfortable, you should not let everything go by itself. A timely visit to a doctor will help avoid the transition of the disease into a chronic form and, possibly, in the future, will save you from such a problem as prostate adenoma or even its malignant tumor.

Ultrasound of the prostate occupies an important place in the range of diagnostic tools in modern urology.At the slightest signs of ill health, the doctor will offer to go through this procedure, as the most informative and at the same time simple and fast.

During an ultrasound scan, the doctor will determine the size of the gland as a whole and its individual sections, assess the structure of its soft tissues and the degree of clarity of the contours, will be able to observe the seminal vesicles in order to identify possible signs of pathology. So you can easily diagnose both inflammatory diseases of the prostate (prostatitis) and the presence of neoplasms. Among them are benign hyperplasia – adenoma, as well as malignant tumors.

You need to undergo an ultrasound of the prostate, if there are such signs of its ill health:

• pain in the lower abdomen;
• Difficulty or painful urination;
• Frequent “trips” to the toilet at night;
• abnormalities in the analysis of semen and urine;
• problems with conceiving a child;
• other disorders of sexual function.

What is included in the preparation for the study.

Ultrasound of the prostate gland requires special preparation so that the results of the study do not cause doubts:

• diet for 2 – 3 days preceding the procedure; the diet should exclude foods that stimulate gas production, as well as constipation or diarrhea;
• a couple of hours before the study, it is necessary to cleanse the intestines with an enema or micro enema;
• do not smoke before ultrasound in order to prevent reflex bowel contractions;
• it is better to undergo the test on an empty stomach by drinking water in front of it to fill the bladder.

How is an ultrasound of the prostate performed and what you need to know about it.

During ultrasound, the doctor can use both transabdominal and transrectal sensors. With the use of the first (TaUS), one can only determine the volumetric pathology of the prostate. That is why more accurate research is carried out transrectally (TRUS).

During TRUS, the patient lies on his side with his knees pulled up to his stomach. The doctor conducts a study with a thin probe through the rectum. The procedure takes 10-15 minutes, less often up to 25 minutes.

Transrectal ultrasound is an unpleasant event, so many are worried about the degree of its pain. Objectively, everything has been done in order to reduce the level of discomfort. So the sensor diameter is only 10 – 15 mm. For better sliding, it is covered with a protective film and a layer of lubricant is applied. The sensor is inserted into the rectum no more than 5 – 7 cm.

In this case, the patient’s pain threshold is of great importance. This is why the sensations range from “very painful” to “quite bearable.”In any case, you can count on the absolute safety of the study.

With age, metabolic processes slow down, fatigue accumulates, and diseases prevail. This is why every man should take care of his prostate gland in advance. After 40 – 45 years, prophylactic ultrasound of the prostate is recommended annually. For this, experienced doctors are waiting for you in our center.

Results of ultrasound of the prostate and prostate pathology.

Several indicators are evaluated during scanning:

• dimensions;
• echogenicity and structure;
• contours.

Normally, the prostate should be symmetrical, have a homogeneous structure, clear and even contours. For a healthy gland, the following dimensions are characteristic:

• anteroposterior – 15-25 mm;
• transverse – 27-42 mm;
• longitudinal – 24- 40 mm.

In the study, such pathologies of the prostate can be identified :

1. Adenoma can manifest itself as an increase in the size of the gland, the presence in it of formations with a weakly echogenic environment.In advanced stages, asymmetry and heterogeneity of the structure are observed.
2. Asymmetry, an increase in the volume of an organ, can be considered a sign of cancer.
3. With inflammation of the gland, the contours become uneven, the structure is heterogeneous. In the acute phase, the dimensions increase, and the echo density becomes lower. In a chronic process, sclerosed hyperechoic areas are determined.
4. Cysts are visualized as fluid bubbles. They are one of the hallmarks of chronic prostatitis.
5. Stones are small inclusions in the ducts of the gland. They are also a sign of a chronic inflammatory process.

Only an andrologist or urologist can evaluate the ultrasound results. The same specialist makes the final diagnosis based on a comprehensive examination. In the Liteiny medical center in St. Petersburg, an ultrasound of the prostate is done using modern equipment, so the examination is quick and painless.

What men need to know to avoid cancer – Rossiyskaya Gazeta

Every third case of cancer in men is either lung cancer or prostate cancer.But if everything is more or less clear with the lungs – smoking is to blame, then how to protect the “second heart” of a man from cancer? Vsevolod Matveev, a well-known urologist-oncologist, deputy director for scientific and innovative work of the NN Blokhin National Medical Research Center of Oncology, Corresponding Member of the Russian Academy of Sciences, spoke about this to “RG-Week”.

The older the man, the higher the risk of developing prostate cancer, in 60-year-olds and older this type of cancer is already in first place. In our country, 38 thousand men die from it every year. What are the reasons for the increased incidence? After all, we will know the reasons – we will be able to defend ourselves.

Vsevolod Matveev : There are several reasons. First, the aging of the population. Cancer occurs mainly in older men. The second reason for the alarming statistics is actually a blessing: we have become more active in detecting early forms of this type of cancer, since in our arsenal there is such a marker as a prostate specific antigen – it is determined by a blood test. A normal PSA level in men indicates the absence of deviations, and exceeding the established norms – they depend on age – may indicate the presence of a pathological process, including oncology.And in such cases, the man must undergo additional tests.

Earlier, when this marker was not yet known, men went to the doctor when symptoms of the disease already appeared. And as a result, the diagnosis was made at a later stage of the disease.

The third point – we see not only an increase in the incidence associated with a more thorough and early diagnosis, but also a true increase. Indeed, prostate cancer is more common today. There is no one reason that would lead to the development of cancer.But there are risk factors: old age, heredity, black race, overweight, sedentary lifestyle, unbalanced diet – fatty foods, diet high in calcium.

What symptoms can indicate that a person has prostate cancer? When does a man need to run to the urologist without delay?

Vsevolod Matveev : Any violations of urination should be alerted – frequent, difficult, painful, admixture of blood in the ejaculate, in the urine.But, of course, similar symptoms occur with other diseases. There are no specific signs that specifically indicate cancer. Therefore, trouble is not a reason for panic, but for a thorough examination.

This type of cancer is not the most severe, it develops slowly, it is not difficult to diagnose it. With prostate cancer, it’s no secret, people today can live 10 years or more.

Vsevolod Matveev: Today in the world, about every fifth man has a probability of contracting prostate cancer.But only one in 30 dies from it. This suggests that in most men, the disease is latent and does not lead to death. In addition, effective treatments have emerged. This difference between morbidity and mortality is not characteristic of all cancers, namely prostate cancer.

What can a man himself do in order not to miss the disease? Should he himself, for example, control the PSA level?

Photo: Infographics “RG” / Leonid Kuleshov / Irina Innocent

Vsevolod Matveev : Here you have to understand: PSA marker is not specific for prostate cancer.It increases not only in malignant tumors, but also in benign hyperplasia (prostate adenoma), in inflammatory diseases, with mechanical action on the prostate gland – massage, instrumental studies. Therefore, the interpretation of the result is a very difficult thing. One cannot judge anything from one analysis, dynamics is important to decide what to do with the patient – take a biopsy or leave him under observation, etc. But this does not mean that this test should be done by everyone in order to “catch” the oncological disease.In Europe, America, large-scale studies have been conducted on the feasibility of screening for prostate cancer based on PSA. Since this type of cancer develops very slowly, there is no need to carry out such studies “just in case”, young patients who do not have any deviations and complaints. The result will not be comparable to the costs. Another thing is early diagnosis, which is carried out if the patient has at least some symptoms. Here a PSA test is required, and the doctor will, of course, prescribe it.

But you asked what the patient himself can do. We welcome the so-called “risk adapted” early diagnosis. If a man knows that his closest relatives had cancer, he should be wary of his health. This is an ironclad reason for doing a PSA test. Moreover, we are talking not only about cases of cancer in the male line, but also in the female line. In men, it is prostate cancer – in the father, brother, and in women, breast cancer – in the mother, sister. The fact is that there are hereditary diseases associated with the mutation of a certain gene, and the presence of this mutation greatly increases the risk of malignant neoplasm.

Can you give specific recommendations?

Vsevolod Matveev : Men, especially those at risk, need to have their first PSA test at 40-45 years old. The indicator should normally be less than one. If it is more than one, then it must be repeated annually. If everything is in order, the next time it can be repeated after 8 years.
For men 60 years old, the approach is the same, but the norms are different. For them, PSA should be less than 2. If more, then you need to repeat the test annually and watch the dynamics.If the result is less than 2, the next check is carried out at age 68.

If there are abnormalities in the PSA test, does this mean that the patient should be examined with an eye to possible cancer?

Vsevolod Matveev : First of all, the analysis needs to be repeated, and if it is still increased, expand the examination to resolve the issue of the need to perform a biopsy. Additional tests such as PHI (Prostate Health Index) and MRI of the prostate (magnetic resonance imaging) can be performed.

Do all patients, if the diagnosis is confirmed, need to start treatment immediately?

Vsevolod Matveev : With regard to non-aggressive forms of prostate cancer, which, as I said, develops slowly, we use this type of therapeutic approach as active observation. That is, the patient does not receive any treatment, but is regularly examined. If there are signs that the tumor is becoming aggressive, begins to grow, then we carry out treatment.Basically, this tactic is applied to elderly patients. If a man of 70-75 years old has found a non-aggressive initial form of prostate cancer, the probability that he will need treatment is no more than 50 percent. He would rather die from other causes – cardiovascular diseases, for example.

Cancer causes fear that is close to horror, although we are told that cancer is treated much better today. But we see that people are still dying from it. What do we have in terms of treatment options for prostate cancer?

Vsevolod Matveev : The treatment options are the same all over the world, and in Russia they are absolutely the same as in other countries.If we are talking about the initial stages, then this is a treatment aimed at healing. As a rule, surgical and radiation methods are used, if necessary, their combination: surgery plus radiation therapy. The surgery can be performed openly, laparoscopically, using robotic systems. There are also many different techniques in radiation therapy, and new ones are constantly being developed. There is interstitial radiation therapy, brachytherapy, there is external conformal radiation therapy, not so long ago they began to use proton therapy, etc.e. The essence is the same. There is radiation therapy and there is surgery. These are the two main treatments for prostate cancer.

If we talk about more advanced stages of cancer, up to the fourth stage, then great success in treatment has been achieved here. Today, patients with even widespread metastases live on average five years, and of course, it is extremely important to preserve the quality of life for such patients. In addition to conventional hormone therapy, which has been used since the 60s and 70s, second, third and fourth line drugs have appeared.Usually, treatment is started based on the stage, symptoms, age of the patient, treatment tolerance, and side effects that arise. All this together makes it possible for an experienced oncologist to decide which drug is preferable at the first stage of treatment, which at the second, etc. Ideally, patients receive all existing drugs, because each one adds something to increase longevity.

Recently, a new isotope preparation of radium-223 chloride, which is used in metastatic prostate cancer, has been registered in Russia.This is a new step in the development of oncology and treatment of prostate cancer. In general, radiation exposure to bone metastases has been used for many years – isotopes of samarium and strontium are used. But these drugs give beta radiation, it negatively affects the bone marrow, hematopoiesis. In addition, their treatment was more palliative in nature, they reduced pain, but did not affect life expectancy. The isotope of radium-223 is a source of alpha radiation, its effect is not so deep, while the bone marrow does not suffer.Accordingly, it is possible to increase the radiation dose to metastases with minimal toxicity to the bone marrow. But most importantly, in addition to the analgesic effect, it acts on tumor cells in bone structures and actually prolongs the life of patients with bone metastases.

How affordable are modern medicines in our country?

Vsevolod Matveev : I can say one thing, the situation is gradually improving. In Moscow, for example, the government buys a huge amount of drugs, our patients are well supplied with drugs.In other regions, the situation is worse. The availability of many drugs is limited. Of course, it is necessary to address the issue of including innovative drugs in treatment standards and protocols, in various restrictive lists, for example, in VED. It is necessary to make the most of the possibilities of high-tech medical care in the field of oncology. It is very important to make sure that even such expensive therapy is available to our patients and is provided free of charge. And yet, in general, if you look at what happened five years ago and now, the situation is improving.

Business card

Photo: RIA Novosti

Vsevolod Matveev .

Graduate of the 1st MMI im. THEM. Sechenov. Has been engaged in medical work since 1990. For several years he worked as a urologist at the Royal Free Hospital, London, received an internship certificate from the Royal College of Surgeons of England. Doctor of Medical Sciences, Professor, Corresponding Member of the Russian Academy of Sciences. Has over 350 scientific papers. Head of the urology department of the N.I.N.N. Blokhin of the Ministry of Health of Russia “. President of the Russian Society of Urological Oncology. Expert of the European Association of Urologists (EAU), section” Prostate Cancer. ” and proven facts: for example, smoked and fried food is evil Meat, fish, eggs, potatoes cooked in hot oil or with “smoke” contain substances that provoke disease.Not so long ago, scientists found out that milk is not at all such a harmless product as we used to think. Scientists at the US National Cancer Institute were the first to identify a pattern: women who consume a lot of dairy products are more likely to develop breast cancer. More recent studies have confirmed that excess milk (more than 4 servings per day) increases the risk of breast and ovarian cancer in women and prostate cancer in men. Scientists explained that milk contains a lot of saturated fatty acids, estrogens, insulin-like growth factors that provoke tumor processes.The risk of prostate cancer in men is also associated with excess calcium in food, and its main source is just dairy products. On the other hand, calcium protects against rectal cancer. So oncologists do not urge men to completely abandon milk, but not to overdo it with its amount and give preference to fermented milk products.

What food can protect against cancer? Antioxidants, which are abundant in fresh vegetables and fruits, are powerful cancer protectors. Lycopene is well studied – there is a lot of it in tomatoes.Such a “protector” as indole-3-carbinol is also very much needed – all types of cabbage are rich in them, especially dark green broccoli. The flavonoid with the long name epigallocatechin-3-gallate, abundant in green tea, is the most active of the four tea catechins. Its anti-cancer efficacy is 100 times higher than that of vitamin C and 25 times higher than that of vitamin E. In countries where green tea is drunk every day, prostate cancer is rare.

Analyzes for prostatitis. Diagnosis of prostatitis

How to define prostatitis – diagnosis and symptoms

You should consult a doctor in our clinic if the patient has the following symptoms:

• pain when urinating, frequent urge, urinary retention;
• burning sensation in the perineum;

90,099 erection problems;

• premature ejaculation;
• pain during bowel movements;

90,099 long nocturnal erections;

• increased fatigue during standard physical activity;
• psychological problems.

If a man observes any of the listed symptoms, this is a reason to see a doctor as soon as possible.

Important! Early prostatitis often has blurred symptoms, which may indicate other diseases, often more dangerous to the health of men.

For this reason, the experience and qualifications of a doctor play a very important role, who can select tests that allow to recognize the disease and exclude the presence of concomitant diseases with a different origin.

A referral for analysis is preceded by a consultation with a doctor, where our specialist will take an anamnesis, and, if there is a suspicion of prostatitis, will refer the patient for a laboratory examination.

What tests need to be taken for prostatitis in men

Prostatitis is the most common disease among the male half, which most often affects those over 30-40 years of age. Therefore, even for those who are young and feeling healthy, it will not be superfluous to find out what examinations are carried out in case of inflammation of the prostate.

If prostatitis is suspected, the following examinations should be done:

• general analysis of urine and blood;
• examination and culture of prostate secretions;
• smear on flora;

90,099 blood for PSA;

90,099 tests for STDs;

• urofluometry;
• TRUSI.

If the pathogen cannot be found, then there is no basis for the diagnosis of bacterial prostatitis.But if the symptoms of the disease are present, then, most likely, the doctor diagnoses abacterial prostatitis. In this case, treatment will focus on suppressing pelvic pain.

Taking anamnesis

Only a doctor can give a referral for tests of the prostate gland after preliminary consultation with the patient and taking an anamnesis. The urologist of the “Polyclinic +1” will ask the patient about the presence of chronic diseases, clarify the complaints, look at the tests for the previous period and their results, if the appeal is not primary.

At this stage, palpation and massage of the prostate are performed – they are indicated in the absence of symptoms of inflammation, if the doctor suspects the onset of the chronic stage of the disease. The state of the gland can be judged by the man’s reaction to massage, the presence of seals, and possible changes in size.

Important! If the condition is acute, massage cannot be done – there are strong painful sensations! The second reason is that massage can provoke the entry of microbes into the bloodstream, which can lead to sepsis.

Prostate secretion analysis

This analysis allows you to identify the presence of an inflammatory process in the gland, to determine abnormalities in its functioning, to identify bleeding and stagnation of secretions, as well as signs of recovery. Together with bacteriological analysis of urine, the analysis is one of the main in the diagnosis of this disease.

Microscopic examination allows you to analyze the detachable gland. Using this method, it is possible to determine the presence of unhealthy impurities, the condition of the prostate and the course of the disease.

In addition, our specialists perform secretion culture, biochemical and cytological examination. The sampling of biomaterial is carried out as follows: the prostate is stimulated intrarectally, after which it secretes its secret (normal fluid is viscous and transparent), which is placed on a glass slide. If the massage did not work and the secret did not stand out, urine is taken for analysis.

Urine analysis for prostatitis in men

This analysis is mandatory.It can be used to determine the presence and number of leukocytes and bacteria, fat bodies and macrophages. To determine the pathogens, the urine bacterial culture method is used. Bacterial sowing allows you to identify the disease in the acute stage. Escherichia coli is a typical causative agent for this disease. With the catarrhal form of prostatitis, a general analysis is not always effective to identify changes. If the disease has passed into an advanced stage, pus in the form of threads is observed in the sediment.

Uroflometry is also used to determine health status.This is a technique that measures the flow rate during urination. With its help, it is possible to determine the functionality of the bladder (the work of the muscular apparatus and contractility), patency.

How to take a urinalysis

The sampling of this biomaterial is carried out in several ways. The first is with a cotton swab, which is applied to the urethra. The tampon absorbs a small amount of urine, which is sent for analysis. To protect the patient from infections, the skin is disinfected before collection.

The second option is to collect urine using a catheter. In this case, you can be completely sure that the likelihood of infection from the external environment will not happen. The collection of biomaterial is carried out with a catheter in compliance with all standards of sterility. The collected analysis is placed in a container, then inoculation is performed. After a couple of days, the doctor can not only determine the type of pathogen by the remains of its DNA in the urine, but also the stage of the disease. Thus, PCR analysis is performed.

Blood test

A general blood test will reveal the inflammatory process by decoding the ESR.If the erythrocyte sedimentation rate has increased, these are typical signs of an inflammatory process. Sometimes inflammation is triggered by the development of allergies.

Popular blood test for prostate disease – PSA. With its help, you can identify a specific antigen that allows you to determine not only prostatitis, but also prostate cancer. In our clinic, two types of tests are performed – general and free PSA. The patient needs to do both analyzes, since it is the ratio of their results that is important for diagnosis.

Bacteriological analysis of semen

In addition to seeding of secretions from the prostate, an analysis of semen culture is possible. It is carried out in the event that the results of the seeding of the secret were not accurate. The study of the ejaculate allows you to obtain accurate data, because the seminal fluid passes through the prostate and contains a secret in its composition. Diagnose prostatitis by a large number of leukocytes, as well as the presence of single erythrocytes.

In the presence of an inflammatory process in the prostate, the immune system is disrupted, and the semen environment changes from acidic to alkaline.This leads to the fact that clots of dead or weak sperm can be seen in the liquid – their number can reach 80%. Hence, it is clear what effect prostatitis has on reproductive function.

If the analysis shows a decrease in sperm in the seminal fluid, this indicates inflammation in the testicular area. If changes in the germ cells are detected, genetic disorders or a failure of the hormonal background can be suspected. The next step will be the direction of diagnostics, which will confirm or exclude oncological processes.

Additional research methods of the prostate

These include:

• general analysis for STDs – allows you to identify sexually transmitted infections;
• TRUS is an ultrasound examination that allows you to identify foci of inflammation, adenoma or oncology using a rectal probe;
• computed tomography – allows you to get a complete picture of the state of the pelvic organs;
• extended spermogram with MAR test and Kruger study – the analysis is prescribed for men who have reproductive disorders: it can be used to determine the quality and number of sperm, as well as whether prostatitis has affected the ability to fertilize.

Additional examination is necessary in case of difficulty in diagnosis or due to the presence of symptoms of the disease, not characteristic of prostatitis. Also, you cannot do without it if the symptomatology arose against the background of a malignant tumor in the pelvic organs. An auxiliary method is vital to obtain a complete picture of a man’s health status and in the event of complications.

Explanation of the analysis results for prostatitis

If you took a urine test, then check first of all for the presence of leukocytes in it – normally their indicator is 3 or less.If ketone bodies are detected, an additional examination is required – the development of diabetes mellitus is possible. There should be no blood in the urine at normal rates.

PCR diagnostics allows you to identify the causative agents of the disease. If everything is normal, they are absent.

If ejaculate was taken for analysis, then normally it should not contain mucus, and the number of leukocytes should not exceed 1 million / ml. Reproductive function will not be impaired if the live sperm count reaches 40-60%.

The norm of the size of the seminal vesicles, which are monitored during TRUS, does not exceed 5 cm. A deviation from this indicator indicates an inflammatory process.

How to prepare for testing for prostatitis

So that the analyzes do not upset with unreliable data, take the preparation procedure seriously. You should not limit yourself to drinking, but the diet needs to be revised. Avoid foods containing natural and artificial colors – including beets, carrots, blueberries, herbs, juices, ascorbic acid pills and more.You should not drink coffee and alcohol 8 hours before the test.

Preparation for the delivery of the analysis depends on what kind of biological material will be examined. If it is necessary to pass smears or scrapings, as well as culture for infections, the patient should:

• do not urinate for 3 hours before taking the test;
• do not use disinfectant soap and care products;

90,099 have not had intercourse in the past 36 hours;

• stop taking antibiotics and uroseptics.

When preparing for the delivery of the spectrogram, you must refrain from sexual intercourse for 5-7 days. Also, refrain from visiting the bath and taking antibiotics, alcohol, carbonated drinks.

Correct preparation for the analysis is a guarantee of an accurate result and well-spent money.

Why contact the “Polyclinic +1”

The urologists of our clinic have not only the appropriate qualifications, but also more than 20 years of experience in the medical center.Our polyclinic has all the latest equipment necessary, which allows us to perform a wide range of examinations for men and guarantee the accuracy of the results obtained.

Contacting our clinic is profitable and convenient for the reason:

• efficiency of obtaining results – depending on the selected analysis, some results can be obtained after half an hour;
• anonymity of the examination – we strictly observe medical confidentiality;
• convenient location of the clinic – a 5-minute walk from four metro stations;
• careful selection by the doctor of the necessary complex of examination – nothing superfluous, only what is needed for accurate diagnosis;
• affordable affordable prices for doctor’s consultations and tests.

Turning to the “Polyclinic +1” you can be sure that the doctor will select the best therapy option that will allow you to get rid of the disease as soon as possible. Come, we are always happy to help!

90,000 11 myths about prostatitis

Disputes about the causes, mechanisms of development and principles of treatment of chronic prostatitis in the urological community continue to this day. Nickel, a leading American expert on prostatitis, considers chronic prostatitis to be the “last frontier” in urology that must be overcome in the 21st century.Recent studies, including in our republic, allow us to look at the problem of prostatitis in a new way, but old views and myths about it still exist among both doctors and patients. Here is some of them.

Prostatitis is a disease of older men.

No. Chronic prostatitis is most often diagnosed in young men who are 20-40 years old. At the age of 60 or more, prostate adenoma or BPH develops, in which prostatitis is a concomitant disease.

Prostatitis occurs due to hypothermia and sedentary work.

No. Acute and chronic prostatitis is caused by infections. Acute inflammation is caused by bacteria, such as E. coli, enterococci and others. Chronic prostatitis develops as a result of the penetration of infectious agents into the tissue of the prostate gland. These include chlamydia, trichomoniasis, genital herpes, and other sexually transmitted diseases. Various stressful situations, including hypothermia, alcohol abuse, colds, contribute to the exacerbation and further development of latent (latent) urogenital infections in men and women.

Prostatitis occurs with sexual abstinence.

No. Lack of sexual activity does not lead to prostatitis. The man’s body adapts to such a situation and self-regulation of sexual function occurs. On the contrary, active and promiscuous intercourse almost always leads to infection with sexually transmitted diseases and the development of prostatitis.

With prostatitis, you often want to go to the toilet and it hurts above the pubis.

Not always.In almost half of cases of chronic prostatitis, there are no such complaints. The patient may be disturbed by redness and burning of the glans penis, itching in the urethra, erectile dysfunction, when the penis is “flaccid” or intercourse lasts less than a minute. Often, a man is not worried about anything at all, and his partner is constantly exacerbated by chronic cystitis or “thrush”. In many cases of infertility, chronic asymptomatic prostatitis is also diagnosed. Prolonged prostatitis affects overall well-being. Weakness, fatigue may disturb.With chlamydia, trichomoniasis, inflammation can also develop in the joints, rectum, conjunctiva of the eyes.

If, according to the results of smears for STIs, nothing is revealed, it means that the patient does not have any genital infections and the cause of prostatitis is some other.

This is most likely not true. In the presence of chronic prostatitis, especially when there have already been courses of treatment, it is most often not possible to identify pathogens in smears from the urethra. Firstly, because in a chronic process, pathogenic microorganisms migrate from the urethra to other organs (prostate).In the urethra, their content is very small, therefore, methods such as RIF, PCR cannot determine them. To identify pathogens, it is necessary to investigate the secret of the prostate gland by cultural methods with the accumulation of these pathogens and, then, to determine the type and nature of urogenital infections. Unfortunately, most laboratories do not carry out such tests.

Prostatitis is not a contagious disease, and one man should be treated.

Wrong. Since the cause of chronic prostatitis is sexually transmitted infections, all sexual partners should be treated.Often women with whom patients with prostatitis have sexual intercourse suffer from recurrent cystitis, inflammatory diseases of the ovaries, and erosions of the cervix. Their treatment gives a temporary effect, if not associated with the results of examination and treatment of the sexual partner.

If a woman is being treated by a gynecologist, and the man is not worried about anything, then he does not need to be treated.

No, not true. Most often, all men whose wives suffer from inflammatory diseases of the genitourinary organs have chronic prostatitis, the presence of which they do not know.Without competent, comprehensive treatment of both partners, there will be no good treatment result.

If a woman has an inflammatory process of the genitals or “some kind of infection”, and the man is not worried about anything, then the gynecologist can prescribe him a “prophylactic trichopolum intake” together with his wife and that will be enough.

The gross mistake of a doctor. The patient should be referred to a urologist for an in-depth examination. Often in such cases, chronic asymptomatic prostatitis is detected, the treatment of which should be long and complex.Trichomoniasis with the correct targeted examination is detected in many cases of chronic urethroprostatitis. The results of recent studies show that the causative agent of trichomoniasis is resistant to drugs from the metronidazole group in half percent of cases. Reception of Trichopolum “1 tablet 3 times a day for 5-7 days” leads in this case to the further development of Trichomonas resistance to drugs, a change in the structure of the pathogen, which greatly complicates the diagnosis and further treatment of the disease.The patient remains a potential carrier of infection. In addition, such inadequate and illiterate treatment can provoke an exacerbation of chronic prostatitis and other complications. When a man comes to a urologist with a delay, it is very difficult to treat him.

Prostatitis must be treated with antibiotics.

Not always. Only in acute prostatitis are antibiotics used, including intramuscularly and intravenously. Most often these are drugs from the groups of fluoroquinolones and cephalosporins.They act on bacteria that cause acute inflammation in the gland. Taking antibiotics for chronic prostatitis will have a temporary effect at best. With viral or protozoal inflammation in the prostate, the use of antibiotics will only worsen the course of the disease.

Prostatitis can be cured with pills and injections alone.

When treated with medication alone, the effect is likely to be insufficient and temporary.Deterioration may occur in a month or two. In the pathogenesis of chronic prostatitis, the presence of a local focus of inflammation in the tissue and ducts of the gland plays an important role. Antibiotics almost do not penetrate into it, therefore, procedures are needed to “resorb” this focus, the introduction of drugs inside it, drainage of the prostate ducts, instillation of the posterior (prostatic) urethra with a catheter. Physiotherapy is of great importance, and powerful pulsed magnetotherapy (Neocontrol) is considered the most effective. Since the cause of prostatitis is most often a mixed microflora, it is necessary to stage, in the correct sequence, prescribed anti-infective treatment.In addition, it is necessary to correct the immunological processes aimed at combating the chronic inflammatory process. Therefore, only a comprehensive, individually selected treatment is most effective in the treatment of chronic prostatitis.

Prostatitis is incurable.

When a patient has been treated for chronic prostatitis for years, uses a lot of different medications, he and his urologist get the impression that this is a disease for the rest of his life.However, studies in recent years show that this is not the case. Three factors are required for the successful treatment of prostatitis:

1. Establishment of a reliable cause of chronic prostatitis by methods of in-depth laboratory diagnostics.
2. Application of individual complex treatment using etiotropic (affecting the pathogen), local and systemic pathogenetic (affecting the inflammatory process in the gland) therapy.
3. Human factor.Often the patient comes to the urologist determined that the doctor is obliged to cure him because he “took the Hippocratic oath”, and the treatment should be the best, special, but at the same time inexpensive. Such a consumerist, one-sided attitude to medicine does not lead to anything good. Treatment of chronic diseases is a creative process that depends not only on the experience and knowledge of the doctor, but also on the human factor. Mutual understanding between the patient and the doctor, respect for each other is necessary. Unfortunately, world medicine is currently switching to the treatment of diseases according to a protocol that clearly states what a doctor should do in a particular pathology, no more, no less.And what kind of treatment to undergo: “protocol” or individual – the choice is for the patient.

An effective treatment for chronic prostatitis should be considered such a treatment, after which all complaints of pain, urinary disorders go away, sexual function is restored, sperm quality is restored, general well-being, performance improves, and relapses of inflammatory diseases in the patient and his partner stop. Experience shows that this result can be achieved in many men suffering from chronic prostatitis.

A. Gavrusev, kmn, ass. Department of Urology BSMU

City Clinical Hospital No. 31 – Prostatitis

Diagnostics

Diagnosis of both acute and chronic prostatitis is rarely difficult for a urologist. First of all, after questioning and general examination, the doctor conducts a digital rectal examination of the prostate gland and taking the secretion of the prostate. This is an unpleasant, and with a pronounced inflammatory process, quite painful, but, unfortunately, an absolutely necessary and irreplaceable procedure.Another diagnostic measure for prostatitis is transrectal sound examination.

Before starting treatment, it is absolutely necessary to do a culture of urine and prostate secretions in the laboratory to determine the sensitivity of the flora to various antibacterial drugs. Without this, the treatment will not be effective, and will not lead to getting rid of the disease, but to its transition to a new, more severe form.

Prostatitis treatment

Prostatitis is a disease so complex that its treatment is a big problem for doctors all over the world.However, this does not mean at all that the doctor cannot help the patient with prostatitis in any way, and there is no point in going to him. It is not always possible to completely cure a patient from prostatitis, but modern medicine is able to eliminate the symptoms of the disease and cause a stable long-term remission. And there, the duration of this period will depend on the patient himself. If he strictly and carefully follows all the doctor’s recommendations, it is very likely that the unpleasant and annoying symptoms will disappear for life.

However, for this, the treatment of prostatitis must be comprehensive and well-chosen. For treatment, measures such as antibiotic therapy, prostate massage, physiotherapy, immunocorrective therapy and lifestyle correction are used. Only a complex of these measures can lead to the desired effect. The treatment of the disease is so difficult that one cannot afford to neglect any of the described methods of treatment. Let’s dwell on each of them separately.

Antibiotic therapy

The use of antibacterial drugs for prostatitis is necessary because it is an infectious disease caused by pathogenic bacteria. The drug for antibiotic therapy must necessarily be selected correctly after appropriate diagnostics, as already mentioned above. The most optimal antibiotics to use are from the group of fluoroquinolones, since they accumulate in the secretion of the prostate gland in the highest concentration.

In addition, we must not forget about the general rules for antibiotic therapy. If it is started, in no case should you interrupt or pause it. If this happens, the diagnosis and treatment will have to be carried out again after a certain time. If, after three days of using the antibiotic, there is no visible improvement in the course of the disease, the drug must necessarily be replaced with another (in no case canceled). You should not use an antibiotic of the same group with a drug that you have recently used to treat any other disease.Before starting treatment, be sure to consult with your doctor on all these issues.

Physiotherapy for prostatitis can be used in a variety of ways, but in any case, its action is aimed at increasing blood circulation in the pelvic organs, which increases the effectiveness of antibiotic therapy. For physiotherapy, electromagnetic oscillations, ultrasonic waves, laser action, or simply an increase in the temperature in the rectum can be used.If it is not possible to carry out physiotherapy, sometimes you can limit yourself to microclysters of various drugs and warm water.

Immunocorrection in prostatitis is often absolutely necessary, since a long course of the inflammatory process and often one or two incorrectly conducted antibiotic therapies in the past cannot but have a negative effect on the state of the immune system. In addition, the treatment of prostatitis is not only to rid the gland of infection and inflammation, but also to prevent the development of inflammation in it again.To conduct a full-fledged antibiotic therapy, it is not enough just to ask the pharmacy “what do you have to increase immunity?”. Most often, for the full treatment of chronic prostatitis, it is necessary to consult an immunologist and conduct a number of special tests.

Normalization of lifestyle is also necessary for both treatment and prevention of prostatitis – after all, if you leave the factors predisposing to the disease unchanged, sooner or later it will reappear.Therefore, it is necessary to make rational changes in your life – playing sports, walking, proper sleep and wakefulness, good and adequate nutrition are a guarantee that this unpleasant disease will leave you in your memory only unpleasant memories.

Inflammation of the prostate is a disease that is much easier to avoid than to cure. Currently, prostatitis has become a multidisciplinary problem when it comes to chronic pelvic pain syndrome.Given the prevalence of the disease, the often latent nature of the clinical picture and consequences, chronic prostatitis is a disease that requires treatment without fail.