Diagnosis and Management
If prostate cancer screening detects an abnormality, you may need one or more of the following tests:
Transrectal Ultrasound and Prostate Biopsy: A small ultrasound probe is placed in the rectum through which systematic and targeted biopsies may be taken from your prostate, about the size and shape of a cigar, is inserted into your rectum.
Magnetic resonance imaging (MRI): In some situations, your doctor may recommend an MRI scan of the prostate before or after a biopsy to better understand your anatomy and to potentially make collecting a sample of prostate tissue more specific to areas of concern. The tissue is analyzed in a pathology lab by experts in urologic pathology and prostate cancer detection.
What happens when you are diagnosed? What information is key to understanding your risk?
When a biopsy confirms the presence of cancer, we look at how aggressive a cancer is, and how much there is under the microscope. These facts are important in predicting what the behavior of the cancer is going to be. A higher grade (higher Gleason score) indicates a more aggressive cancer may spread if not treated soon. Gleason scores used to assess prostate biopsy samples range from 6 to 10. A score of 6 indicates a low-grade prostate cancer. A score of 7 indicates a medium-grade prostate cancer. Scores from 8 to 10 indicate high-grade cancers. There are other genetic techniques which show us which genes are “turned on” in the tumor, which also helps understand how aggressive or not aggressive the cancer is.
How do we know if the Cancer has Spread?
There are various techniques and technologies that help understand if your cancer has spread beyond the confines of the prostate. A CT scan surveys your chest, abdomen and pelvis, and is necessary along with the bone scan to ensure that the bones remain free and clear of disease. There are also various statistical prediction tools ( MSK NOMOGRAM, and SUNNYBROOK NOMOGRAM) that are key in establishing the risk of local extension from the prostate, lymph nodes spread, as well as giving you a very clear idea about your risk of living cancer-free once treated at 5 and 10 years.
One or more of the following imaging tests may be recommended:
- Bone scan
- Ultrasound
- Computerized tomography (CT) scan
- Magnetic resonance imaging (MRI)
- Positron emission tomography (PET) scan ( PSMA Pet)
Not every test is needed for every patient. Dr. Feifer will help determine which tests are best for your individual situation. This information is key to understanding what your stage of cancer is, the lowest stages indicate the cancer is confined to the prostate. By stage IV, the cancer has grown beyond the prostate and may have spread to other areas of the body.
TREATMENTS & CONDITIONS
Benign Prostate Gland Enlargement (BPH)
Benign prostatic hyperplasia (BPH), also called prostate gland enlargement, is a common age associated condition. An
Prostate Cancer
Prostate cancer is one of the most common cancers in males. When caught early, it has an excellent prognosis. Patients with advanced disease and now have an abundance
Surgery, Medical Management of BPH
When BPH needs to be treated, the first thing that is trying is a modification of lifestyle factors. There may be food
Male Voiding Dysfunction
The lower urinary tract in the male includes the bladder, prostate and urethra, which allows for storage and timely expulsion of urine. Voiding dysfunction describes a condition
