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Prostate Cancer Detection

Prostate Cancer Symptoms:
In its early stages, prostate cancer often doesn't produce any symptoms. Symptoms that may however indicate prostate cancer include:

  • Frequent daytime or nighttime urination
  • Urgency in urinating
  • Trouble starting your urine stream
  • A weak or interrupted urine stream
  • Pain or burning during urination
  • A feeling that your bladder doesn't empty completely
  • Blood in the urine
  • Pain in the back, hips or pelvis

Although these symptoms can be caused by prostate cancer, they also can be caused by other conditions that are not cancer. A very common one is benign prostatic hyperplasia (BPH). As men age, the prostate often enlarges and can press on and block the urethra and bladder, producing some of the symptoms described above. BPH can be successfully treated with medication or surgery.

Prostate Cancer Screening:
A digital rectal examination (DRE) and the prostate-specific antigen (PSA) test are the two primary methods by which prostate cancer is detected. The combination of the two helps increase the chance of detecting cancer when present.

  • Digital Rectal Examination - During a DRE, a medical provider inserts a gloved, lubricated finger into a man's rectum to feel for any irregularities of the prostate. Many, but not all, prostate cancers can be detected this way.
  • Prostate-Specific Antigen Test - PSA is a protein in the blood that is produced by prostate cells. PSA reflects the volume of both benign and malignant prostate tissue. The higher the PSA level, the more likely that prostate cancer is present. However, having a high PSA doesn't always mean that you have cancer. Certain activities and conditions can produce a high PSA, including benign prostatic hyperplasia; ejaculation up to three days prior to the testing; a recent prostate biopsy; a urinary tract infection; and prostatitis, an inflammation of the prostate that usually is treated successfully with antibiotics.

Prostate Cancer Diagnosis:
If the PSA and DRE are suspicious for a possible prostate cancer, the provider may discuss with you the opportunity to formally diagnose prostate cancer through a transrectal ultrasound (TRUS) guided prostate biopsy. Using an ultrasound to visualize the prostate, approximately 10-12 biopsies of the prostate are taken. It is typically performed as an office procedure and takes less than 30 minutes, and usually causes minimal discomfort and occasionally some bleeding. An antibiotic is given before and after the procedure to reduce risk of infection.

Jeong Yoon, MD
January 2013