The prostate is a subject usually discussed behind closed doors in a doctor’s office. As modern medicine has stretched the average age of men well beyond 70 years old prostate cancer is becoming a mainstream topic. This article will discuss prostate cancer diagnostic procedures, a relatively new prostate cancer treatment procedure, and healthy prostate maintenance.
Let’s start with the PSA test, (Prostate Specific Antigen). PSA is a substance secreted by the prostate at the time of ejaculation for sperm motility and protection. In other words, PSA is a transport medium to keep sperm alive. It’s not a cancer marker.
A blood test of your PSA tells the doctor how much PSA is circulating in your blood system and nothing more. An elevated PSA reading may tell your doctor that additional monitoring would be prudent. PSA will naturally rise after sex, riding a horse, riding a motorcycle/bicycle, a digital rectal exam, a heavy workout and jogging/running. TRT, Testosterone Replacement Therapy, will also give an elevated PSA reading. If your doctor schedules a PSA test, he should warn you not to perturb your prostate for 72 hours prior to the test. In follow-up testing it has been found that an elevated PSA reading has shown to be 80% inconclusive.
The digital rectal exam is another method of testing for prostate cancer. During the exam the doctor will feel the prostate for any abnormalities. The problem with the digital rectal
exam is that the doctor is only able to feel half of the prostate and leaves unknown what lies on the other side of the prostate, so the digital rectal exam can be inconclusive.
The twelve-needle biopsy prostate cancer testing method inserts needles into the prostate to probe for cancer cells. As the prostate can be as large as a ping-pong ball and the needles not much larger than a needle used to draw blood the needles are only
able to probe about one percent of the prostate interior. If no cancer is detected a second twelve-needle biopsy will be ordered at a later date, and even then, a positive finding may be elusive, thus rendering the twelve-needle biopsy in many cases inconclusive.
Whichever testing method used, if prostate cancer is found or suspected your doctor will order a prostatectomy. This involves removal of part or all of the prostate. In most cases incontinence and the ability to perform in the bedroom will be negatively affected either temporarily or permanently. There is a 50% probability that neither normal urine flow nor bedroom performance will return either in the short term or long term. Thus, has been the plight of men experiencing prostate cancer.
The newest technology
In 2012 in Europe a new technique was developed to diagnose and treat prostate cancer. It’s known as TULSA, trans urethra ultrasound ablation. TULSA is a non-surgical procedure using pin-point accuracy made possible by an MRI. An MRI is used to locate any cancer cells or masses within the prostate. Once the cancer is located the doctor will map out the location within the prostate to be treated. The patient is then placed inside an MRI unit and given a mild sedative after which the ablation instrument is inserted up the penis to the prostate. From that point on the doctor will guide the ablating instrument using the live MRI image of the prostate. The doctor will use one of two settings on the instrument during the ablation process. The high intensity setting is used to treat the cancer mass, while the medium intensity setting is used when working around any nerve bundles affecting ejaculation and urination. During the procedure non-targeted tissue is kept cool with a continuous flow of water.
Side effects of TULSA are minimal to non-existent. In Europe the TULSA procedure has replaced most of the above-mentioned testing procedures and surgeries. Dr Joseph Busch of Busch Center in Atlanta, Georgia has been operating with the TULSA procedure for about twelve years and believes that TULSA will replace the radical prostatectomy once the public becomes informed of its advantages.
Explaning Gleason Scores, prostate grading
Prostate cancer cells are graded into five categories, Number 1 being the lowest grade of cancer and Number 5 the highest grade. When a biopsy is viewed under a microscope the most predominate category of cancer cells is noted then the next most predominant category of cancer cells are added to that number for a total score, (3+4 or 4+3).
A Gleason Score of 6 is considered a low-grade cancer, 7 is intermediate, and a score of 8 to 10 is a high-grade cancer. A Gleason Score of 3+4 is less dangerous than a score of 4+3 as the 4 score denotes the more dangerous cancer and is less predominant in the 3+4 and more predominate in the 4+3 making the 4+3 a more dangerous cancer reading. The doctor will take a guarded view of a total score of 7.
A revised prostate cancer grading system was presented in 2014 named the Grade Group. The grade group system is simpler and consist of five groups.
