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Diagnosing prostate cancer

If you need initial information on matters such as the function of the prostate, possible diseases of the prostate, detection of prostate cancer, and treatment of prostate cancer, the following two free publications are highly recommended as introductory reading:
  • Localised prostate cancer: a guide for men and their families (2010) (4th edition). Produced by the Australian Cancer Network. The contents of this very readable booklet provide more information that its title suggests. The first two chapters provide an explanation of what prostate cancer is, and methods used to diagnose prostate cancer. Later content deals with treatment options. The authors indicate that the booklet is ‘...particularly designed for men who have localised prostate cancer (which has not spread beyond the prostate gland). It explains what localised prostate cancer is, the treatment options and their pros and cons. Its purpose is to help men make decisions about these treatments.’ Available for free by post or download as a 2.0 MB PDF file from here.  
     
  • Understanding prostate cancer - A guide for men with cancer, their families and friends, (2011). Publisher: Cancer Council NSW. Download the free booklet as a 979 KB PDF file from this web site page.
The following paragraphs provide only very brief notes relating to the nature of prostate cancer and its diagnosis.

What is the prostate?

This page on the web site of the Prostate Cancer Foundation of Australia (PCFA) provides a brief description of the nature, location and function of the prostate gland.

Main disorders of the prostate

That page on the also provides a brief description of the four main disorders of the prostate:   
  • Prostatitis (described briefly on this page on the Andrology Australia's site)
  • BPH - Benign Prostatic Hyperplasia or BPE - Benign Prostatic Enlargement (described briefly on this page on the Andrology Australia's site)
  • Prostatodynia
  • Prostate cancer

Detection of prostate cancer

Unlike other diseases of the urinary tract, prostate cancer usually develops without any noticeable symptoms. It is usually detected through the following means:

  • PSA testing: A small amount of blood is taken using a syringe, and the level of PSA (Prostate Specific Antigen) is measured through a laboratory test. In addition, a statistic called "% free PSA" may be determined from the sample, as that yields further indicative information. It should be noted that the PSA test does not provide an incontrovertible proof of the existence or absence of prostate cancer - the results provide indicative information only. 
     
  • A DRE (Digital Rectal Examination) may be undertaken by your GP or urologist. This involves insertion of a gloved finger into the rectum, and feeling for any abnormalities in the prostate gland. This procedure only takes a few seconds and involves only very minor discomfort. Again, the results of such an examination only provide indicative information, because not all of the prostate gland can be felt through a DRE.
     
  • If any of the above tests yield results which are abnormal for one's age, the GP or urologist may advise the patient to undergo a procedure called a "biopsy" of the prostate gland. This procedure is undertaken in a hospital. Samples of tissue are taken from the prostate gland and analysed under a microscope by a pathologist. This procedure is explained in simple terms here.
     
  • If the biopsy indicates the presence of prostate cancer the urologist may propose imaging scans to be undertaken to determine the extent to which the prostate cancer is localised within the prostate or spread outside the prostate.
When should a PSA test be undertaken?

The PSA test is usually the initial means of getting information that is indicative of the need for furthermore definitive testing for prostate cancer. While there are some differences in the policies of authoritative bodies in Australia in relation to PSA testing and DRE, the views of the PCFA should be noted:
  • The policy of the Prostate Cancer Foundation of Australia that men at 50 with no family history of prostate cancer and men at 40 with a family history, should seek voluntary annual assessments in the form of a PSA blood test together with a DRE. Its full policy on this is here and a recent explanatory statement here.


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