Screening and Testing for Prostate Cancer
Some prostate cancer screening tests are used because they have been shown to be helpful in finding cancers early and decreasing the chance of dying from these cancers.
Scientists study screening tests to find those with the fewest risks and most benefits. Cancer screening trials also are meant to show whether early detection decreases a person's chance of dying from the disease. For some types of cancer, finding and treating the disease at an early stage may result in a better chance of recovery.
Tests to detect prostate cancer include:
- Digital Rectal Exam (DRE)
During a DRE, the doctor or nurse inserts a lubricated, gloved finger into the lower part of the rectum to feel the prostate for lumps or anything else that seems unusual.
- Prostate-Specific Antigen (PSA) Test
This test measures the level of PSA in the blood. PSA is a substance made mostly by the prostate that may be found in an increased amount in the blood of men who have prostate cancer. The level of PSA may also be high in men who have an infection or inflammation of the prostate or benign prostatic hyperplasia (enlargement of the prostate gland).
Scientists are studying the combination of PSA testing and using a digital rectal exam as a way to get more accurate results from screening tests. Some cancers never cause symptoms or become life-threatening, but if found by a screening test, the cancer may be treated. It is not known if treatment of these cancers would extend life longer than if no treatment were given, and treatments for cancer may have serious side effects. Follow-up tests, such as a biopsy, may also be done to diagnose cancer.
- Transrectal Ultrasound (TRUS)
Transrectal ultrasound uses sound waves to make an image of the prostate on a video screen. For this test, a small probe is placed in the rectum. It gives off sound waves, which enter the prostate and create echoes that are picked up by the probe. A computer turns the pattern of echoes into a black and white image of the prostate. The procedure takes only a few minutes and is done in a doctor's office or outpatient clinic. You will feel some pressure when the TRUS probe is placed in your rectum, but it is usually not painful.
A biopsy is a procedure in which a sample of tissue is removed and then examined under a microscope. The doctor will use transrectal ultrasound (TRUS) for guidance and insert a narrow needle through the wall of your rectum into several areas of your prostate gland. The needle then removes a cylinder of tissue, usually about 1/2-inch long and 1/16-inch across, that is sent to the laboratory to see if cancer is present.
Healthy prostate cells are uniform in size and shape, neatly arranged in the patterns of a normal gland. As cancer spreads, cells lose their uniform appearance. They change from normal, well-differentiated tissues to more disorganized, poorly differentiated tissue. Eventually, a tumor develops. If your biopsy shows the presence of prostate cancer, the pathologist assigns each tissue sample a grade, indicating how far the cells have traveled along the path from normal to abnormal.
The process used to find out if cancer has spread within the prostate or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment.
da Vinci Treatment Options for Prostate Cancer
All surgery presents risk, including da Vinci Surgery. Results, including cosmetic results, may vary. Serious complications may occur may occur in any surgery, up to and including death. Examples of serious and life-threatening complications, which may require hospitalization, include injury to tissues or organs; bleeding; infection, and internal scarring that can cause long-lasting dysfunction or pain. Temporary pain or nerve injury has been linked to the inverted position often used during abdominal and pelvic surgery. Patients should understand that risks of surgery include potential for human error and potential for equipment failure. Risk specific to minimally invasive surgery may include: a longer operative time; the need to convert the procedure to an open approach; or the need for additional or larger incision sites. Converting the procedure to open could mean a longer operative time, long time under anesthesia, and could lead to increased complications. Research suggests that there may be an increased risk of incision-site hernia with single-incision surgery. Patients who bleed easily, have abnormal blood clotting, are pregnant or morbidly obese are typically not candidates for minimally invasive surgery, including da Vinci Surgery. Other surgical approaches are available. Patients should review the risks associated with all surgical approaches. They should talk to their doctors about their surgical experience and to decide if da Vinci is right for them. For more complete information on surgical risks, safety and indications for use, please refer to http://www.davincisurgery.com/da-vinci-surgery/safety-information.php.
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PN 1002336 Rev A 04/2013 U 07/06/2012