An elevated PSA level in the blood is often the only indicator of the presence of prostate cancer (in the early stages). PSA (Prostate Specific Antigen) is a protein that is formed in prostate tissue and is present in the blood of a healthy man in small quantities. An increase in PSA levels in the blood may indicate the presence of prostate cancer. But an elevated PSA level does not always indicate the presence of cancer. With (benign enlargement) and inflammation of the prostate (prostatitis), the PSA level also increases.
Therefore, a good urologist does not make a diagnosis based solely on a PSA blood test (and rectal examination of the prostate), but uses additional methods to diagnose prostate cancer. Such as an MRI scan (or another version of computed tomography).
Normal PSA level in the blood
With age, PSA levels in the blood of healthy men increase. At the age of 40-49 years, the normal level is considered to be 2.5 ng/ml (nanograms per milliliter); 50-59 years - 3.5 ng/ml; 60-69 years old - 4.5 ng/ml; 70-79 years old - 6.5 ng/ml.
Typically, doctors are wary if you are 45-55 years old and your PSA level in the blood is above 4 ng/ml. Although with benign prostate adenoma, the PSA level also often exceeds 4. According to studies in the USA, if the PSA level in the blood is below 4 ng/ml, then the chance that a biopsy will reveal prostate cancer is 15%. If a patient's PSA level is between 4 and 10 ng/ml, then the probability that he has prostate cancer is about 25%. If the PSA level in the blood exceeds 10 ng/ml, then the chance of prostate cancer increases to 50% (and increases as the PSA level further increases).
To make an accurate diagnosis, doctors use not only your PSA blood level in combination with your age, but also other PSA parameters (and additional ones):
— Rate of increase in PSA levels: doctors compare blood tests done at different times;
— The ratio of free and bound PSA: PSA protein can be found in the blood both in free form and in bound form. To clarify the diagnosis, not only the total PSA level is important, but also the ratio of free and bound PSA.
In other words, a PSA blood test is just an indication of the possible presence of prostate cancer, and not a definitive diagnosis. In addition, correctly interpret the analysis results
PSA test after treatment for prostate cancer
A PSA blood test is used not only for cancer, but also to detect relapse (return) of cancer after treatment. For example, when the prostate and all tissues affected by metastases are completely removed, the PSA level drops to zero. If, during a subsequent PSA test, its level begins to increase, it means that tissues affected by cancer remain in the body.
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Article on the topic: "tests for prostate cancer: how to determine the disease?" Find out more about treating the disease.
Briefly about the disease
Malignant formations in the prostate are characterized by their uncontrolled reproduction; cancer cells bypass immune defenses and cannot be destroyed by the body on its own. They mutate and have a toxic effect on humans, disrupting the normal functioning of not only the affected organ, but also all major systems of the body.
The main danger of cancer to life is the possibility of the malignancy spreading to other organs, this is called metastasis. When lymph nodes, muscles, bones, lungs, and kidneys are affected by metastases, maintaining a person’s life becomes impossible and he dies.
Prostate cancer is most common among older men and is due to the negative hormonal changes that come with aging. The mortality rate from malignant tumors of the prostate gland is 30%.
- They work in harmful conditions.
- They do not lead a healthy lifestyle.
- They have a hereditary predisposition.
Many deaths from malignant tumors occur because the cancer is not detected in the early stages, and in the later stages, even the most effective measures do not guarantee a cure for the disease. This makes timely and accurate diagnosis of prostate cancer in men an important process.
Diagnostic methods
The oncologist is responsible for issuing referrals for all prostate cancer tests and possible examinations. For some procedures, referrals can be made by a urologist and a general practitioner. The main methods for detecting cancer are represented by the following methods:
- Blood test for prostate specific antigen (PSA). This antigen is produced by the prostate gland and thins the sperm. To determine its concentration, venous blood is taken for analysis. The average price of this diagnostic procedure is 500-700 rubles. Interpretation of analyzes:
- For men under the age of 50, the norm is a PSA level of 2.5 ng/ml.
- For men aged 50-60 years, the normal antigen concentration is 3.5 ng/ml.
- For men aged 60-70, the norm is 4.5 ng/ml.
- In the early stages of cancer, the PSA concentration is 4-10 ng/ml.
- Late stages correspond to an antigen content of 10 ng/ml or more.
A PSA blood test is a kind of test for prostate cancer. It is also important to pay attention to changes in antigen concentration over time. Even slight increases in the amount of PSA in the blood indicate the development of pathological processes. A favorable outcome of therapeutic procedures will be indicated by a decrease in the amount of antigen.
If a digital examination does not reveal signs of a tumor, but the PSA index is high, then additional examinations are carried out - blood tests for prostate cancer, on the basis of which the prostate health index is derived.
- A biopsy is a similar analysis of the cellular composition of an organ. A biopsy allows you to clarify the results obtained during the PSA test. The test is painful and is performed under local anesthesia. There are three ways to remove part of the prostate tissue:
- Transureal.
- Transperineal.
- Transrectal.
The methods differ in the routes of penetration to the prostate tissue: through the urethra, through the perineal region and through the anus, respectively.
Each method involves the use of ultrasound sensors to track the position of the prostate and the biopsy instrument. The instrument is a medical gun or needle; it penetrates the prostate tissue, cuts it and takes a small piece for testing. To avoid the development of infectious processes, incision and puncture sites are treated with antibiotics.
The biopsy results are expressed as a Gleason score. A healthy state of the prostate corresponds to a score of 2 points, 5-7 points indicate a high risk of developing malignant tumors, a score of 7 points or more corresponds to the presence of cancer cells.
- Prostate MRI is an examination of the prostate gland and surrounding organs using a magnetic field that reacts with body tissue and forms an image on a monitor. The procedure is absolutely painless, the only difficulties that may arise with it are the need to give up dairy products and products with coarse fiber several days before the examination, as well as the long time it takes to perform an MRI (about 40 minutes). There are several types of MRI for prostate cancer that can help clarify the diagnosis:
- With the introduction of an endorectal coil into the anus. It changes the focus of the magnetic field, which is concentrated directly in the prostate area. This is the most effective type of MRI, but it is relatively unpleasant for humans.
- With the introduction of a contrast agent into the blood. The drug may cause side effects such as increased heart rate and a bad taste in the mouth.
- With simultaneous performance of a spectrogram.
- Ultrasound examination (ultrasound). Ultrasound waves are sent to the prostate area, they are reflected from the organ and create an echo recorded by the sensor. The echo signals are converted into an image, which is used to analyze the condition of the organ.
Ultrasound can be directed through the abdominal wall, through the rectum, or through the urethra. Transrectal ultrasound has the greatest accuracy, but it costs more than the classic examination through the abdominal wall. To carry out the procedure, you need to empty your bowels with an enema and fill your bladder by drinking one and a half liters of still clean water.
By analyzing the image of the ultrasound results for prostate cancer on the monitor, the doctor draws conclusions about the size of the prostate, the presence of tumors and their location. If necessary, more accurate diagnostic methods indicated above (biopsy, MRI) are prescribed.
Conclusion
Timely diagnosis of prostate cancer is vital. The latest examination methods make it possible to detect the disease in its infancy.
A man should not be afraid to go to the hospital even with minor negative symptoms, since most diagnostic methods are painless for a person.
Prostatitis
Localized prostate cancer often occurs without any noticeable symptoms or manifestations. One way to detect this disease is through regular testing to determine PSA level in the blood.
Prostate-specific antigen (PSA) is considered a type of protein produced exclusively by prostate cells. Protein levels are measured using a blood test. Doctors advise men aged 50-75 to get a PSA test every year. If a young man has first-degree relatives who have had prostate cancer, he is recommended to start being examined earlier.
When PSA levels are determined, doctors take into account the size of the prostate gland. The larger the gland, the higher the PSA level. Moreover, prostatitis occurs in men even with low PSA levels. The presence of prostate specific antigen in the blood can be in both bound and free form.
Indicators of PSA level in the blood: values, likelihood of cancer
There are norms for PSA concentrations for each specific age group:
- V 40-49 years old blood PSA level< 2,5 мкг/л;
- V 50-59 years old - < 3,5 мкг/л;
- V 60-69 years old - < 4,5 мкг/л;
- V 70-79 years old -
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All men over 50 years of age are at risk for prostate cancer. At an earlier age, prostate diseases are diagnosed quite rarely. Carcinoma can go through a long development process, and the moment of its onset is very difficult to determine, because there are practically no external signs. Sometimes a process of spread to neighboring organs occurs. The possibility of developing prostate cancer depends on testosterone levels. This affects men who are overweight or overweight. They usually lead a sedentary lifestyle and prefer fatty foods. It is recommended that men who have had cases of prostate cancer among their immediate family undergo additional examinations. Based on the first symptoms, cancer can be confused with prostatitis and the formation of adenoma. On this basis, if you have problems with urination, it is recommended to consult a doctor and undergo an examination.
Symptoms of cancer
- Frequent urge to urinate, which is accompanied by pain, especially at night.
- Presence of blood in urine and semen.
- Feeling of aching in the joints and spine.
With timely diagnosis, it is possible to completely cure prostate cancer.
Prostate cancer development and necessary tests
Experts distinguish three stages of prostate cancer:- Stage 1 is a small tumor in the prostate that has not affected nearby organs;
- Stage 2, when the tumor grows and spreads to neighboring organs;
- Stage 3 – metastases affect other organs.
The second stage is most often diagnosed. In order to detect prostate cancer earlier, it is recommended to carry out preventive examinations after 40 years.
To undergo a complete examination, you need to do several mandatory tests:
- A blood test that will help determine the level of antigen in it. If the standard level is exceeded, the development of prostate cancer can be diagnosed. But for a final diagnosis, in addition to a blood test, confirmation by an additional examination will be required.
- Local examination must be carried out through the rectum. It is necessary to palpate the prostate and determine whether there are changes in its size.
- After this, a biopsy is usually prescribed. It is carried out in a medical institution using special equipment; local anesthesia is allowed.
- The resulting tissue sample needs detailed examination. These results can confirm or refute the preliminary diagnosis.
- Sonography of the prostate is performed using ultrasound. A probe is inserted through the anus and a specialist examines the prostate.
Only after a comprehensive examination can a urologist diagnose prostate cancer.
Diagnosis of prostate cancer
Diagnosis of prostate cancer takes a certain period. In this case, side diseases may begin to appear. In this regard, scientific research is constantly being carried out in this area. All middle-aged men can have a blood test for the prevention and early detection of prostate cancer. It is able to detect PSA - prostate-specific antigen. If a large amount of it is detected during a blood test, it can be recognized that there is a real possibility of developing cancer. A PSA level of more than 20 nanograms may suggest the development of cancer. When levels are more than 50 nanograms, the lymph nodes are affected, and when it approaches or exceeds 100 nanograms, we are talking about the number of metastases. In such a situation, it is necessary to undergo additional procedures. Mandatory of which will be a rectal examination of the prostate gland. The urologist will be able to determine the formation of a tumor by touch. If you suspect prostate cancer, you must refrain from drinking alcohol and drugs. Follow a diet and follow all doctor's recommendations. The correct diagnosis and the ability to begin treatment may depend on these components. There are cases when oncology begins to develop with a low level of antigen. The patient experiences discomfort, pain, and tests cannot explain this, including a blood test. Therefore, it is better to go through all stages of the examination sequentially.
Before performing prostate and blood tests, it is recommended not to have sex for 2 days. This can ensure the purity of the results obtained.
Diagnosis of advanced stages of prostate cancer
To monitor the course of the disease, it may be necessary to conduct examinations and tests of other organs. With the development of prostate cancer, lymph nodes located in the pelvic organs and bone tissues can be affected.
It is necessary to conduct tests for the presence of cancer markers, and it will be possible to detect the disease at an early stage.
For examination, it is necessary to conduct a scintigram, computed tomography, magnetic resonance imaging, and x-ray. This is necessary to find out where the cancer cells are and how susceptible the entire body is to the disease. Be sure to examine the condition of the bones, and a scintigram will be able to determine the progress of metabolic processes. X-rays are taken because it is very common for cancer cells to appear in the lungs during the development of prostate cancer. A detailed blood test allows you to make a correct diagnosis and obtain information about your health status. It is carried out in medical laboratories. The results can be ready on the day of delivery. Based on the results, the doctor will be able to judge the stage of development of prostate cancer and the need for surgical intervention. But a blood test alone cannot make a diagnosis. Therefore, it must be comprehensive.
To monitor the patient's health, blood tests may be performed quite frequently. This helps the specialist adjust the treatment and recognize its effectiveness.
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Cancer is a disease that requires a comprehensive approach to diagnosis. Such a diagnosis can be reliably made only after a series of studies. But routine tests, which can be easily done in almost any laboratory, will help you suspect this disease. It is laboratory diagnostics that helps to determine which organ is associated with possible problems, and to specifically look for their cause.
Complete blood test: will it show cancer?
A malignant tumor is an actively growing tissue that requires a large amount of “building material” and energy. It actively consumes substances necessary for the growth of the body and releases metabolic products, including toxic ones. The main changes that can be seen in the results of a blood test are associated with these two processes.
Intoxication leads to an increase in ESR, an increase in the number of neutrophils and a decrease in the number of lymphocytes. If these signs are accompanied by weakness, fatigue, loss of appetite and weight loss, the most serious diagnosis must be excluded as soon as possible. This combination of symptoms manifests itself most clearly in some forms of lymphogranulomatosis, histiocytosis and neuroblastomas.
With tumors of internal organs, the hematopoietic system often suffers and hemoglobin decreases. The toxic effect of waste products of tumor cells damages the membranes of red blood cells, which is why their pathological forms - echinocytes - can appear in the blood. In bone marrow cancer, immature blood cells are found.
Blood tests for cancer are carried out in the same way as for any other disease. In the treatment room, whole blood is collected from the patient into a specially prepared tube. You need to donate biomaterial on an empty stomach or at least 4 hours after eating. The result will be ready in 1–2 business days.
The specificity of such a test is low, and it is impossible to diagnose cancer based on the results of a blood test alone. The same increase in ESR is always observed during inflammation. Anemia can occur due to poor nutrition, iron deficiency, or other diseases.
General urine analysis for the diagnosis of cancer
Specific changes rarely appear in urine tests for oncology. But any deviations in the results are a reason to conduct a more thorough examination.
Blood in the urine is an early symptom of bladder or urinary tract cancer. But it can also appear with urolithiasis or glomerulonephritis.
Ketone bodies indicate enhanced processes of catabolism, that is, tissue breakdown. This sign can appear both during a tumor process and, for example, with diabetes or during a diet.
To carry out the analysis, collect the morning urine sample in a sterile container. Before collecting the material, you need to take a shower so that cells from the surface of the skin do not get into the container.
In just 1-2 days the result will be ready and you need to consult a doctor. It is impossible to make a diagnosis or even suspect oncology using a single urine test. It is necessary to take into account other results of tests and examinations, as well as existing symptoms.
Biochemical blood test: signals of a tumor process
In a biochemical blood test, seven indicators are most important for diagnosing cancer:
- Total protein and albumin. Tumors actively consume protein, which causes its level in the blood to decrease. Plus, appetite is often lost, and building material for cells ceases to enter the body in sufficient quantities. And if cancer affects the liver, then protein production in the body is significantly reduced, even with a normal diet.
- Urea. An increase in this indicator in the blood indicates a deterioration in kidney function or active protein breakdown. This can occur both during tumor intoxication and during the breakdown of tumor tissue, including during effective cancer treatment.
- Changes in blood sugar levels can be observed with sarcomas, cancer of the lungs, liver, organs of the reproductive system, and other types of oncology. Tumor cells inhibit insulin production, and the body begins to respond untimely to increased glucose concentrations. As a result, signs of diabetes mellitus may appear several years before the first clinical symptoms of cancer. This happens especially often with breast and uterine cancer.
- Bilirubin increases with liver damage, including cancer.
- ALT is an enzyme that can increase both in case of tumor damage to the liver and in other diseases.
- Increased alkaline phosphatase is a sign of bone tumors, bone metastases, liver damage, gallbladder damage from the main tumor or metastases.
Blood for this study is taken from a vein. It is advisable to take the biomaterial in the morning before breakfast, otherwise you may get a false result. This is a fairly quick analysis and its results can be found out within 1-2 days.
However, the specificity of the biochemical analysis is also very low. Changes in blood tests for oncology do not allow an unambiguous diagnosis. Rather, any violations are a signal for the doctor to conduct a more thorough diagnosis of certain systems or organs.
Blood clotting tests for cancer
In oncology, blood clotting significantly increases, the risk of thrombosis of large vessels and the formation of microthrombi in capillaries increases.
Historical reference
The connection between cancer and increased thrombus formation was first identified by A. Trousseau in 1861. Since then, this theory has not been questioned, but has only been confirmed by new scientific data.The formation of microthrombi, in turn, worsens the course of the oncological process. The circle closes. Serious studies have been conducted that have shown that the use of drugs that reduce blood clotting improves the survival of cancer patients, even with advanced malignant processes.
To identify coagulation disorders, a coagulogram is examined. This test will also require blood from a vein. And the results will be ready in 1-3 business days.
Immunological blood test: a key test method for cancer
A blood test for cancer markers allows you to suspect oncology at an early stage, assess the dynamics of the disease, timely determine relapse or the appearance of new metastases, and evaluate the effectiveness of treatment.
Tumor markers are substances that are associated with the vital activity of a tumor and in the body of a healthy person are either not detected at all or are contained in very small quantities. More than 200 similar substances are known. But not all of them are equally successfully determined in medical practice.
On a note
In 2017, for the purpose of early detection of renal cell cancer, methods for determining new tumor markers - aquaporin-1 and perilipin-2 - were developed. The methods have 95 percent sensitivity and 91 percent specificity.Despite the fact that the determination of tumor markers has become known as a “blood test for cancer,” their detection does not indicate with a 100% guarantee the presence of this disease and requires additional examination.
For diagnosing tumors using a blood test, the most significant markers are α-fetoprotein and β-chorionic gonadotropin, which are determined in certain types of tumors of the ovary, body and cervix. As well as prostate-specific antigen PSA, which increases in prostate cancer.
The second most important is CA-125, which is detected in serous ovarian cancer. Other tumor markers are less widely used:
- for breast tumors, CEA, CA-15-3 and CA-72-4 are determined;
- if cervical cancer is suspected, SCC is determined in addition to alpha-fetoprotein and hCG;
- for colon cancer - CEA and CA-72-4;
- if a gastric tumor is suspected - CEA, CA-72-4 and CA-19-9;
- if pancreatic cancer is suspected - CA-19-9 and CA-242;
- for thyroid cancer - hTERT, EMC1, TMPRSS4, galectin-3, EGFR, HBME-1;
- in case of bladder cancer, VTA, UBC, NMP-22 are determined in the urine.
A blood test for cancer markers is performed on an empty stomach or 4 hours after eating. Blood is taken from a vein. The analysis is carried out within 1–2 business days. If the result is needed urgently, it can be done in a few hours.
Cytological studies: an integral part of oncology diagnostics
Of all the laboratory methods for diagnosing cancer, cytology has the highest specificity. Using cytology, you can almost always reliably make a diagnosis and determine the type of tumor. The sensitivity of this method depends on the type of cancer and on how well the material for the study was taken. For example, if cancer cells do not get into the washing water, the test will give a negative result, although the tumor itself may develop.
When conducting the study, the doctor takes into account more than 180 different signs of cell atypia. Such an analysis allows not only to say whether there are signs of an oncological process, but also to determine the source of the tumor, its histological variant, and to distinguish the primary tumor from metastasis.
Cytological examination is carried out for tumors of almost any location - skin, lungs, ovaries, uterus, lymph nodes, bone marrow, liver, and any subcutaneous formations.
For research, you can take fingerprint smears from the surface of the skin or mucous membranes, smears from the cervix or vagina, sputum, urine, and any other discharge. In order to examine lesions located under the surface of the skin, a puncture is performed - the material is taken using a syringe with a needle. Using a puncture, you can collect biomaterial from the thyroid gland, lymph nodes, bone marrow, areas of the liver, and from any other formations.
The results of the cytological examination are usually issued a week after the sample is taken. There are cases when doctors show the received drugs to their colleagues and compare them with the archive. Then the study can take up to two weeks. But in this case, it’s worth waiting, because the more thoroughly the research is carried out, the more accurate the result will be.
A general, biochemical analysis and coagulogram will not help detect cancer using a single blood test. But with their help, you can identify those organs that require special attention and plan a full examination. The same applies to urine analysis.
A blood test for tumor markers can provide more information related specifically to the possibility of developing a cancerous tumor. But it cannot be considered separately from the general condition. It is better to conduct research on several tumor markers at once, which indicate a certain type of cancer - this will increase the reliability of the diagnosis.
Characterized by their uncontrolled proliferation, cancer cells bypass immune defenses and cannot be destroyed by the body on its own. They mutate and have a toxic effect on humans, disrupting the normal functioning of not only the affected organ, but also all major systems of the body.
The main danger of cancer to life is the possibility of the malignancy spreading to other organs, this is called. When lymph nodes, muscles, bones, lungs, and kidneys are affected by metastases, maintaining a person’s life becomes impossible and he dies.
Prostate cancer is most common among older men and is due to the negative hormonal changes that come with aging. The mortality rate from malignant tumors is 30%.
Also at risk are men who:
- They work in harmful conditions.
- They do not lead a healthy lifestyle.
- They have a hereditary predisposition.
Many deaths from malignant tumors occur because the cancer is not detected in the early stages, and in the later stages, even the most effective measures do not guarantee a cure for the disease. This makes timely and accurate diagnosis of prostate cancer in men an important process.
Diagnostic methods
The oncologist is responsible for issuing referrals for all prostate cancer tests and possible examinations. For some procedures, referrals can be made by a urologist and a general practitioner. The main methods for detecting cancer are represented by the following methods:
- Blood test for (PSA). This antigen is produced by the prostate gland and thins the sperm. To determine its concentration, venous blood is taken for analysis. The average price of this diagnostic procedure is 500-700 rubles.
Interpretation of analyzes:- For men under the age of 50, the norm is a PSA level of 2.5 ng/ml.
- For men aged 50-60 years, the normal antigen concentration is 3.5 ng/ml.
- For men aged 60-70, the norm is 4.5 ng/ml.
- In the early stages of cancer, the PSA concentration is 4-10 ng/ml.
- Late stages correspond to an antigen content of 10 ng/ml or more.
A PSA blood test is a kind of test for prostate cancer. It is also important to pay attention to changes in antigen concentration over time. Even slight increases in the amount of PSA in the blood indicate the development of pathological processes. A favorable outcome of therapeutic procedures will be indicated by a decrease in the amount of antigen.
If a digital examination reveals no signs of a tumor, but the PSA index is high, then additional examinations are carried out - blood tests for prostate cancer, on the basis of which a diagnosis is made.
- is a similar analysis of the cellular composition of an organ. A biopsy allows you to clarify the results obtained during the PSA test.
The test is painful and is performed under local anesthesia. There are three ways to remove part of the prostate tissue:- Transureal.
- Transperineal.
- Transrectal.
The methods differ in the routes of penetration to the prostate tissue: through the urethra, through the perineal region and through the anus, respectively.
Each method involves the use of ultrasound sensors to track the position of the prostate and the biopsy instrument. The instrument is a medical gun or needle; it penetrates the prostate tissue, cuts it and takes a small piece for testing. To avoid the development of infectious processes, incision and puncture sites are treated with antibiotics.
The results of the biopsy are formulated as a score according to. A healthy state of the prostate corresponds to a score of 2 points, 5-7 points indicate a high risk of developing malignant tumors, a score of 7 points or more corresponds to the presence of cancer cells.
- is an examination of the prostate gland and surrounding organs using a magnetic field that reacts with body tissues and forms an image on the monitor. The procedure is absolutely painless, the only difficulties that may arise with it are the need to give up dairy products and products with coarse fiber several days before the examination, as well as the long time it takes to perform an MRI (about 40 minutes).
There are several types of MRI for prostate cancer that can help clarify the diagnosis:- With the introduction of an endorectal coil into the anus. It changes the focus of the magnetic field, which is concentrated directly in the prostate area. This is the most effective type of MRI, but it is relatively unpleasant for humans.
- With the introduction of a contrast agent into the blood. The drug may cause side effects such as increased heart rate and a bad taste in the mouth.
- With simultaneous performance of a spectrogram.
(ultrasound). Ultrasound waves are sent to the prostate area, they are reflected from the organ and create an echo recorded by the sensor. The echo signals are converted into an image, which is used to analyze the condition of the organ. Ultrasound can be directed through the abdominal wall, through the rectum, or through the urethra. Has the greatest accuracy, but it costs more than the classic examination through the abdominal wall. To carry out the procedure, you need to empty your bowels with an enema and fill your bladder by drinking one and a half liters of still clean water.
By analyzing the images of ultrasound results for prostate cancer on the monitor, the doctor draws conclusions about the presence of tumors and their location. If necessary, more accurate diagnostic methods indicated above (biopsy, MRI) are prescribed.
Conclusion
Timely diagnosis of prostate cancer is vital. The latest examination methods make it possible to detect the disease in its infancy.
A man should not be afraid to go to the hospital even with minor negative symptoms, since most diagnostic methods are painless for a person.
Early diagnosis of prostate cancer is the main condition for effective treatment, as a result of which a man maintains not only health, but also reproductive function at a younger age and the ability to lead a full life without special restrictions at an older age. A timely blood test for prostate cancer is very important at this stage.
There is still no exact answer to the question of why carcinoma occurs and at what stage the cells of the epithelial and other tissues of the prostate gland begin to multiply uncontrollably. But it is absolutely clear that cancer does not occur on a healthy prostate; it is already a derivative of the primary disease (prostatitis, prostate adenoma, etc.). The development of prostatic intraepithelial neoplasia (PIN) can be considered a prerequisite for the appearance of a malignant tumor. Therefore, if the patient has already been diagnosed with any pathology of the prostate gland, it is necessary to immediately begin treatment. This is the main prevention of oncology.
Prostate cancer and its successful treatment are affected not only by timely diagnosis, but also by prevention:
- healthy lifestyle;
- regular examination over the age of 40;
- careful attention to your health.
Those who have had cases of prostate cancer among close relatives should pay special attention to their health. Those who have been exposed to radioactive radiation, work in hazardous industries, or live in environmentally unfavorable regions are also at risk.
The success of treating the disease largely depends on the stage of the diagnosed tumor. If cancer is detected at the very beginning, then relapses and complications are practically excluded. The second and subsequent stages of prostate cancer are characterized by tumor growth and invasion into adjacent tissues and organs.
The biggest danger is the ability to metastasize. Malignant cells can spread through the blood and lymph flow beyond the tumor, affecting the lymph nodes and bones in the pelvic area, and in the final stages - other organs and groups of organs (lungs, kidneys, gastrointestinal tract, etc.). A characteristic feature has been noted - when the lymph nodes are affected, the bone tissue does not suffer and vice versa.
According to statistics, about a third of diagnosed patients die even with appropriate therapy because the disease was diagnosed too late. Therefore, the sooner a man is examined, the more favorable the prognosis. The age factor sometimes interferes with the timely detection of cancer at the initial stage, since in this case prostate hyperplasia is already taken for granted and it is believed that conservative drug therapy is sufficient. Meanwhile, constant observation by a doctor and full compliance with the rules of treatment and prevention is the key to a complete cure without relapses.
Why take a blood test?
If oncology is suspected, the doctor writes out a referral for tests (this can be either an oncologist or the attending urologist). A full examination includes:
- manual examination (palpation of the prostate gland);
- blood analysis;
- biopsy;
- ultrasonography.
If necessary, these basic methods are supplemented with magnetic resonance imaging, fluoroscopy, etc., in order to obtain the most accurate and reliable clinical picture possible.
Since the symptoms of prostate cancer (prostate cancer) are similar to the symptoms of some other diseases of the urogenital area, differential diagnosis is mandatory. Thus, a palpation examination may show a significant enlargement of the prostate with BPH (benign prostatic hyperplasia), and the results of a blood test for early-stage prostate cancer in middle age may be identical to the norm for older (over 60) men.
A blood test is needed to determine your prostate specific antigen (PSA) level. This antigen is produced by the prostate to liquefy sperm. For this analysis, venous blood is taken. The normal indicators for different age groups look like this:
- up to 50 years - 2.5 ng/ml;
- from 50 to 60 years - 3.5 ng/ml;
- over 70 years old - 4.5 ng/ml.
Indicators of 4–10 ng/ml correspond to the initial stage of cancer. The lower limit of the concentration of prostate specific antigen can be compared with the readings of the older age group, so additional research is needed. The growth of a tumor is more accurately diagnosed with the help of several repeated blood tests. If an increase in the concentration of a specific antigen is observed, it is possible to say with a high degree of probability that the tumor is malignant. The faster the growth rate and the shorter the intervals between blood samples for laboratory testing, the higher the likelihood that the patient has a cancerous tumor.
If the first two methods of examination - palpation of the prostate and a blood test - cause discrepancies (for example, a manual rectal examination did not reveal any significant enlargement of the prostate, and the PSA concentration is high), it is necessary, firstly, to do repeated blood tests, and secondly , use other methods of examining the prostate.
After diagnosing prostate cancer and starting a course of therapy, it is necessary to monitor the patient’s condition and the effectiveness of the prescribed treatment using control blood tests.
If tests show a decrease in PSA concentration and its approach to normal values for a given age, then the treatment is successful.
How to donate blood correctly
A referral for tests must be issued at least a week before the blood draw. The reason is that for the purity of the analysis, some restrictions regarding nutrition and other aspects of human life are necessary. The first thing you need to give up is alcohol. Its use should be stopped a week before the test. Two full days before the procedure, you must exclude fatty, spicy and fried foods from your diet. The prostate cancer test itself is done on an empty stomach, so you cannot eat anything 8 hours before the blood draw.
This test requires sexual abstinence for 24 hours before the test. You should also not smoke for 3 hours before the procedure. You are allowed to drink unlimited amounts of water, and on the last day before the test you need to exert yourself physically as much as your age and physical condition allow.
Failure to comply with these rules will lead to the fact that the reliability of the analysis results will be in question, and distorted data can significantly complicate the diagnosis and the prescription of effective treatment. Correct blood tests are important because it is necessary to determine the dynamics of PSA values and, on this basis, determine how to treat the tumor.
How the analysis is refined
To clarify the blood test for prostatic antigen, a biopsy is prescribed. This is a collection of prostate cells for more detailed analysis. The procedure is carried out in three ways:
- transurethral;
- transperineal;
- transrectal.
Using special instruments, the prostate is punctured through the urethra, perineum or anus. This procedure is performed under local anesthesia, since the tissues in these sections are richly innervated and therefore very reflexogenic. The resulting tissue sample is examined and assessed according to the Gleason scale, where 2 points are normal, 5 points are a risk group, and above 7 points are malignant degeneration of the tumor.
If necessary, more complete material is collected using x-rays, tomography, ultrasound and other methods. Each of them has its own fence rules and restrictions. For example, 3 days before an MRI, you need to give up fermented milk products and coarse fiber (bran bread, raw vegetables and fruits, etc.), and for transrectal ultrasound, in addition to a cleansing enema, you need to fill the bladder, for which the patient is offered before the study drink at least one and a half liters of clean still water.
A comprehensive examination allows you to diagnose a tumor with higher accuracy than using any one method.
You should not delay going to the doctor if you feel unwell and signs of ill health. Men should be especially wary of symptoms such as:
- difficulty urinating;
- blood and/or pus in the urine;
- pain in the perineum, lower spine, pelvic area.
These symptoms may indicate that the cancer has already entered the second stage, so you should not hesitate to seek medical help.
A blood test for prostate cancer is a simple procedure that does not require special equipment. It is needed to determine the development of a tumor at the initial stage, as well as to monitor the effectiveness of treatment after diagnosis.
Diagnosis of prostate cancer in men at the earliest stages of its formation is the primary task of medical workers. The disease most often occurs in men aged 45–65 years and older, when there are already inflammatory processes and hyperplasia in the tissues of the organs. Therefore, it is inappropriate to evaluate only subjective complaints. Mandatory laboratory and instrumental examinations are required for a man who comes in with suspected prostate cancer. If detected early, cancer has a very favorable prognosis.
Precancerous conditions and provoking factors
Most middle-aged men have certain abnormalities in the activity of their “second heart” - the prostate gland. They can live for years with an already formed cancer focus, without even knowing about their illness.
The causes of prostate cancer in men can be the following precancerous conditions:
- Atypical organ hyperplasia - nodules form in the parenchyma of the prostate tissue, the cells in which change their structure and begin to multiply faster under the influence of negative factors from the outside or from the inside. In a situation predisposing to this, a focus of cancer may well arise.
- Hyperplasia with malignancy - increased in volume, for example, due to the chronic course of prostatitis, the prostate gland, under the influence of aggressive factors, suddenly begins to change in its individual areas, the cells change structure, become malignant, transforming into cancer.
The risk of developing prostate cancer in men is increased by the following negative factors:
- abuse of tobacco and alcohol products;
- work in hazardous industries, with constant intoxication with harmful substances;
- advanced age of the man;
- frequent exacerbation of infectious diseases of the pelvic region of men;
- severe long-term stressful situations;
- a significant weakening of a man’s immune structures – a state of immunodeficiency;
- negative hereditary predisposition.
Men who have one or more of the above predisposing factors need to pay close attention to their health and be sure to undergo an annual preventive medical examination, including examination of the prostate gland for cancer.
Warning signs
Having reached a certain age and caring about maintaining their health at a high level, men often ask a specialist during a preventive visit how to identify prostate cancer before obvious symptoms appear.
Warning signs such as various urinary disorders help to suspect a malignant process in the prostate area. Thus, a man begins to be increasingly bothered by the urge to visit the toilet, especially in the evening and at night. Whereas complete urine discharge is not observed - it comes out in meager portions, sometimes even drops.
At the same time, dissatisfaction with urination remains - a feeling of incomplete emptying of the bladder, its overcrowding. The man still has the desire to urinate, but either there is nothing to go out, or there are obstacles to doing so.
Less often, the process of visiting the toilet is accompanied by discomfort in the pelvis and sacral region. Pain impulses in men are inconsistent, intermittent, and aching in nature. More often they are perceived by them as manifestations of other pathologies, such as prostatitis, for example. It is impossible to diagnose a cancer focus based on this sign alone.
What makes men seek medical help is the appearance of blood clots in the urine, a change in its color to a darker shade, “bloody,” the color of “meat slop.” In severe cases of the disease, a man may experience acute urinary retention, without the presence of conditions predisposing to this. Or kidney failure develops - the appearance of severe weakness, dry mouth in a man and a constant feeling of thirst, pain in the lumbar region, and severe exhaustion of the body. Immediate specialized medical care is required.
However, most often, prostate cancer at stages 1–2 of its appearance in a man does not manifest itself in any way. Prostate cancer becomes an extremely unpleasant surprise during a preventive annual examination at the clinic.
Prostate cancer or adenoma
Not wanting to waste his time visiting hospitals and laboratories, or, fearing to hear the terrible diagnosis of cancer, the man delays conducting a comprehensive examination. By doing this, he causes significant harm to his health, attributing the appearance of unpleasant sensations to the course of age-related prostate hyperplasia.
While early diagnosis is the key to success in carrying out treatment measures and returning to full health. Cancer of the male organ should not be confused with adenoma. A characteristic difference between these two purely male diseases is the appearance of atypical cancer cells. But without a special analysis - a biopsy, differentiation is simply impossible.
Prostate adenoma in men is a benign pathology. But under certain conditions - exposure to traumatic factors, it can degenerate into a malignant process. However, there is no clear relationship between these two diseases - cancer and adenoma.
Another distinguishing feature may be tumor growth. Most often, the focus of cancer in a man’s prostate organ grows outward, while with an adenoma it grows not only outward, but also inward. Both lead to problems with the urethra in men. The enlarging prostate puts pressure on the urinary canal. Laboratory and instrumental examinations are required to confirm or refute cancer in men.
The timing of the onset of alarming symptoms is also important - prostate adenoma in a man can have a sluggish course for several decades, periodically disturbing him. Prostate cancer, after 2–4 years, in the absence of proper treatment, will affect your well-being - it will sharply worsen. The man’s disease progresses and causes severe complications.
Early symptoms of prostate cancer
The course of cancer in the tissues of the prostate gland has its own specific order - if at the first stage of the formation of a focus of atypia, as a rule, there are no specific manifestations, then nothing bothers the man.
Much will depend on the type of cancer, the size of the tumor, and the man’s initial health condition. A laboratory test such as blood testing for PSA, a male hormone that enters the bloodstream when the gland malfunctions, helps to detect cancer. In a healthy man, its parameters range from 0.5 to 1 ng/ml. An increase in the value of glycoprotein may indicate both an inflammatory process in the organ and the emergence of a cancer focus. The specialist will evaluate all information from laboratory and instrumental examinations.
A careful history taking of a man reveals that he has been bothered for some time by symptoms in the prostate such as:
- problems with starting to urinate – there is a urge, but urine does not separate;
- the stream flows out weakly, intermittently, even in drops;
- there is a feeling that the bladder remains full;
- possible presence of urinary incontinence - to varying degrees;
- the urge to visit the toilet prevails at night and in the evening, but during the day the man’s need to empty his bladder remains unchanged;
- when urine begins to flow out, there is discomfort, even pain, in the canal itself or in the small pelvis; similar symptoms can be observed after the end of urine flow;
- often exacerbation of pathologies of the male genitourinary system - urethritis, pyelonephritis, prostatitis.
Identification of the listed prostate disorders, the symptoms and signs of which have not previously been observed in a man - all this requires mandatory clarification and diagnostic measures.
Laboratory and instrumental examinations for prostate cancer
Diagnosis of prostate cancer is based on the main verification method - taking biomaterial for cytological examination. A biopsy allows you to assess the presence of cancer cells in the parenchyma of an organ, their number, structure, high or low differentiation.
All this will contribute to making an adequate diagnosis of cancer. Other methods recommended by a specialist are auxiliary:
- rectal examination - palpation of the prostate by a doctor through the rectum, a mandatory examination of men after 40 years of age, which allows us to determine the initial stage of the formation of the disease;
- an increase in the concentration of prostate-specific antigen in the bloodstream - if it exceeds more than 10, a prostate biopsy is required;
- Ultrasound – visualization of the prostate, clarification of the presence of nodes, compactions, and other deviations from the norm in the prostate parenchyma;
- CT, MRI of the male pelvic structures - assessment of the prevalence of the tumor process, involvement of other tissues and organs, and lymph nodes in cancer;
- PET-CT is effective for searching for small metastases, for example, those entering the prostate gland from another primary cancer site.
Only the completeness of information, carefully studied by a urologist-oncologist, allows him to conduct an adequate differential diagnosis. This can cause some difficulties, especially if a man already has benign tumors in the prostate gland. However, a highly qualified specialist will not only make a full diagnosis of cancer in a timely manner, but will also select the appropriate treatment. Early seeking medical help will improve the prognosis for prostate cancer.
What you can do on your own
In order to promptly identify such a disease as dangerous with its complications and consequences as cancer in the structure of the prostate organ, a man is recommended to take the following preventive measures:
- closely monitor your own health - listen to signals coming from all organs, especially the pelvis and prostate;
- timely treatment of all foci of inflammatory and infectious lesions, including prostate adenoma or hyperplasia;
- follow the recommendations of an andrologist - taking preventive anti-inflammatory drugs, taking laboratory tests;
- avoid general or local hypothermia - the prostate is quite susceptible to low temperatures and can often become inflamed because of this;
- perceive sexual contacts not only as pleasure, but also as a measure to prevent congestion in the pelvis, and, therefore, cancer.
If a man suddenly begins to be bothered by urinary disorders, burning, discomfort, or weakening of the stream, it is recommended to immediately consult a doctor again. Early detection of cancer is the key to successful fight against it and recovery.
