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| an examination to determine if there are any palpable abnormalities in size or shape. While abnormalities of this kind do not necessarily indicate cancer, they indicate the need for further testing. Approximately one-third of all DRE abnormalities are eventually diagnosed as prostate cancer. |
| TRUS (Transrectal Untrasonography). In this procedure, a rectal probe is used. to pass sound waves from the probe to the prostate gland. Since cancer cells differ from normal cells in the way they absorb sound waves, the distinct patterns of cancer cells indicate the presence of prostate cancer. |
| Biopsy. If there are abnormalities in both the PSA and DRE, a biopsy will most likely be recommended. Biopsies are usually performed using ultrasound-guiding techniques. occasionally a number of random biopsies will be done to sample the entire prostate gland. |
| I am not in favor of biopsies, because they may disturb the cancer, causing it to grow more rapidly and/or to spread to other areas. I would prefer to see research focus on finding new noninvasive procedures rather than on developing surgical or other invasive practices for detecting and treating this disease. Although MRI (magnetic resonance imaging) is sometimes recommended, studies have shown that it is not a reliable diagnostic procedure for prostate cancer. 17 |
| Grading and Staging |
| After the presence of prostate cancer has been positively identified, conventional treatment options will depend largely on the appearance of the cancer cells under the microscope, a process known as tumor grading. Once the tumor's characteristics have been assessed in this way, the next step is to determine the stage, or extent, of the cancer. |
| Grading |
| The most common way to grade prostate cancer is the Gleason scoring system. This system defines five glandular patterns of cancer cells under low magnification, ranging from 1 (well-differentiated cells) to 5 (completely undifferentiated cells). Some tumors possess more than one cellular pattern; in that case, both patterns are graded and the grades are combined to get a Gleason score ranging from 2 (1+1) to 10 (5+5). Those tumors graded in the low range are significantly less likely to grow rapidly and spread; those with a |
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