Healthcare: Cancer Care

Prostate Cancer Diagnosis

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Did You Know?

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A man has about a 1 in 10 chance of being diagnosed with prostate cancer. Over 200,000 new cases of prostate cancer are diagnosed annually in the United States.

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How Is Prostate Cancer Diagnosed?

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Screening for prostate cancer can be performed in a physician's office or other testing site using: the PSA (prostate-specific antigen) blood test and the DRE (digital rectal exam).

The American Cancer Society recommends that men age 50 and above should have both tests performed annually. Men at high risk, such as African-American men and men with a strong family history should begin testing at age 45. Men who may be at even higher risk, due to multiple relatives with prostate cancer, or relatives diagnosed at an early age, should begin testing at age 40.

Schedule an appointment today for your annual exam, or call Baylor College of Medicine for prostate cancer screening dates.

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Biopsy

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Although screening is essential, prostate cancer can only be conclusively diagnosed from the results of a biopsy. During a biopsy, a hollow needle is used to remove small tissue samples from the prostate. The procedure is typically performed in the office under general anesthesia. The tissue samples are then carefully examined under a microscope, checking for cancer cells.

Although most physicians take from a number of samples when performing a biopsy for prostate cancer, BCM physicians use a more precise technique. This allows them to check for cancerous cells across the entire prostate and indicates how much of the prostate must be removed. Biopsy is also used following surgery to check for the presence of cancer or the success of the operation.

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Gleason Score

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The grade of the cancer is a measure of its aggressiveness. It is determined by the pathologist based on the biopsy. The scale most commonly used in the United States is the "Gleason scale." The Gleason score actually consists of two digits and their sum (for instance, Gleason 3 + 3 = 6).

The individual numbers reflect the two most common patterns within the cancer. Each pattern is scored on a scale of 1 to 5 (1 is the least and 5 is the most aggressive). Thus, the total Gleason score consists of the numbers 2 to 10 (i.e., a minimum of 1 + 1 = 2 and a maximum of 5 + 5 = 10). Your doctor uses both the total Gleason score and the individual Gleason scores when making treatment decisions and recommendations.