Prostate cancer is the second most common type of cancer found in men. This disease is also the second leading cause of cancer-related deaths among men. However, this disease is different from many other types of cancers because it is slow-growing and can often go undetected, primarily due to a lack of debilitating symptoms.
Screening for cancerous cells in the prostate is important because it can lead to an early diagnosis and better treatment outcomes. The most common type of screening test is the prostate-specific antigen test (PSA test). The PSA test is a blood test that is normally used to detect either cancer or prostate-related health issues.
What is a PSA Test?
Prostate-specific antigen (also known as “PSA”) is a substance created by the prostate gland. PSA levels can be tested in the blood and can be used as a marker to identify different prostate diseases, including cancers.
Do PSA Screenings Effectively Detect Cancer in Men?
The PSA test is popular because it is a simple blood test, but it can’t always detect prostate cancer. As a matter of fact, the PSA test can lead to both false positives and false negatives for cancer of the prostate. It is typical for a man, once he reaches 40 years old, to undergo a PSA test to determine whether his PSA level is normal for his age range. However, there are four possible outcomes of this test, which include the following:
- Your PSA is normal and you DO NOT have cancer (a true negative).
- Your PSA is higher than normal and you DO have the disease (a true positive).
- Your PSA is higher than normal but you DO NOT have cancer (a false positive).
- Your PSA is normal but you DO have prostate cancer (a false negative).
As a matter of fact, elevated PSA levels can be due to a number of factors unrelated to cancer, including age-related enlargement, inflammation, or infection. In addition, certain everyday activities, such as riding a bike or having sex, can trigger a temporary increase in PSA levels. According to studies published by Harvard Medical School, up to 20% of men with normal PSA levels still have cancerous tissue, while up to 70% of men with elevated PSA levels do not.
Because a PSA test isn’t the most reliable method of identifying prostate cancer, it’s important to identify symptoms that indicate that more extensive diagnostic testing is needed. If you experience any of the following symptoms, it’s important to make an appointment with the expert team of urology specialists at the Prostate Cancer Institute of Los Angeles.
- Urinary changes, either in frequency or difficulty
- Sexual changes, either in difficulty or an increase in pain
- Swelling or numbness to the prostate, penis or testicles
- Prolonged pain or stiffness in the lower half of the body
If a patient experiences any of these symptoms, it is necessary to undergo further diagnostic testing to determine if cancerous tissue is present.
Learn more about prostate cancer by visiting the American Cancer Society.
Effective Diagnostic Tests
Traditional Biopsy Method
The traditional biopsy method uses an ultrasound probe to perform a prostate cancer test. A biopsy needle passes through the lining of the back passage to take various samples of the prostate tissue from each of the six zones in your prostate. While this method is good at identifying larger tumors, it often misses smaller cancerous areas.
MRI Fusion Biopsies
An MRI fusion biopsy is an innovative combination of MRI and ultrasound technology, which provides prostate imaging and makes for greater accuracy in identifying areas of cancer (in addition to greater precision in sample extraction).
MRI prostate biopsies are brief minimally invasive procedures. They provide patients with early detection, which was previously unavailable with traditional prostate biopsy methods.
The Advantage of MRI Fusion Biopsies
MRI fusion biopsies are able to access the entire gland, including harder-to-reach tissue previously undetected through traditional prostate cancer testing methods. This innovation leads to earlier diagnosis and improved treatment outcomes with the following benefits:
- Detects twice as many prostate gland cancers, in all stages, over a traditional biopsy
- Three dimensional-guided biopsy offers better targeting and precision for locating tumors and identifying areas for treatment
- Targets suspicious areas for biopsy, reducing the need for repeat or unnecessary biopsies
- Increases the detection rate of aggressive cancer cells
- Reduces the over-treatment of low-grade cancer
- Efficient and pain-free procedure
Prostate Cancer Tests in a Nutshell
- PSA tests are simple blood tests, but can’t identify all cases of cancer
- A traditional biopsy is good for identifying large tumors
- MRI fusion biopsies can not only identify cancerous tissue, but also provide a roadmap for radiation therapy after surgery
When to Get Your Prostate Biopsy
A prostate cancer biopsy helps a urologist identify prostate cancer in patients. Yet the right time for a prostate cancer biopsy varies based on the patient.
A urologist may recommend a prostate cancer biopsy for several reasons, including:
- A PSA test indicates a patient’s PSA levels are higher than normal based on age group
- A digital rectal exam reveals lumps or other abnormalities in the prostate
- A patient previously received a biopsy that was normal, but the patient’s PSA levels are still higher than normal
- A previous biopsy indicated that a patient is dealing with prostate tissue cells that are abnormal but not cancerous
How to Prepare for a Prostate Biopsy
Before a prostate biopsy, a urologist may request a urine sample from a patient to detect a urinary tract infection (UTI). If a urologist identifies a UTI, he or she may provide a patient with antibiotics to treat the infection. The urologist may postpone the prostate cancer biopsy until the patient’s UTI disappears, too.
Aspirin, ibuprofen, and other medications sometimes increase a patient’s risk of bleeding. As such, a urologist may recommend a patient stop taking these medications for several days before a prostate biopsy.
Additionally, a urologist typically asks a patient to perform a cleansing enema before a prostate biopsy. He or she also requests a patient take antibiotics approximately 30 to 60 minutes before the procedure; these antibiotics help reduce a patient’s risk of infection.
What to Expect During a Prostate Biopsy
There are two types of prostate biopsies: transrectal and transperineal. During a transrectal biopsy, a urologist moves the biopsy needle through the rectum wall. Comparatively, during a transperineal biopsy, a urologist makes a tiny cut in the skin area between the anus and scrotum. He or she then inserts the biopsy needle into the cut to access the prostate and obtain a tissue sample.
A prostate cancer biopsy usually requires about 10 to 20 minutes to complete. After the procedure, a patient may experience minor soreness and light bleeding from the rectum. Some patients may also experience blood in their urine or stools in the first few days after a prostate biopsy.
Risks Associated with a Prostate Biopsy
As a patient tries to determine if now is the right time for a prostate biopsy, it is important to note that there are some risks associated with the procedure. Common prostate cancer biopsy risks include:
- Rectal bleeding
- Blood in the semen or urine
- Infection
- Difficulty urinating
A urologist outlines the risks associated with a prostate biopsy before the procedure. He or she also responds to a patient’s prostate cancer biopsy concerns or questions.
Contact the Prostate Cancer Institute of Los Angeles
While some prostate cancer symptoms don’t mean you have the disease, don’t ignore any symptoms you do have, especially if they persist. To discuss your condition, contact one of our expert urologists online or by calling 310.341.2557 and schedule a consultation today.
Next, read our blog, What are the Warning Signs and Symptoms of Prostate Cancer?