Early diagnosis of a tumor in the prostate considerably increases the chances of its cure. Therefore, it is important that all men have annual check-ups, or from 45 years of age if they have a family history of prostate cancer cases. The following tests are performed to arrive at the diagnosis of prostate cancer :
Rectal examination
This is the fundamental method of diagnostic approach, so a digital rectal examination and annual PSA (tumor marker) evaluation is usually recommended for men over 50 years of age in order to detect prostate tumors early.
In rectal examination, all stages except T1 are detected, which, as seen in the TNM classification, is an incidental finding.
To the touch, the carcinoma presents as an irregular hard nodule.
Tumor markers
Prostatic acid phosphatase (FAP) is a specific marker, but when the cancer rises it is usually already spread outside the prostate, so it is not useful in early diagnosis.
Prostate specific antigen (PSA) is a marker of prostate tissue (that is, the more prostate mass there is, the higher it will be), and its levels are usually more increased in cancer, but they can also be elevated due to benign pathology, so if it is not greatly increased, in isolation it does not target cancer.
PSA values and possible relationship with prostate cancer:
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- Less than 4 ng / ml: cancer unlikely.
- Greater than 10 ng / ml: increased chances of cancer, so a biopsy is performed.
- Between 4 and 10 ng / ml: other parameters should be used to assess the need for a biopsy.
Imaging tests
Ultrasound through the rectum is the most useful to check the local staging, since in addition to evaluating the prostate, nearby structures are seen.
TAC
The computed tomography (CT) and magnetic resonance imaging are primarily used to evaluate the nodes and metastases.
The bone scan is used in the detection of bone metastases, and is often done when there is suspicion that have occurred these lesions, ie, if the score on Gleason score is very high and so is the PSA, since it is necessary to find out if there are metastases, especially when considering treatment.
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Prostate biopsy
It is done to confirm the diagnosis of prostate cancer. It is indicated if cancer is suspected, either due to digital rectal examination, increased tumor markers, or if any alteration has been observed in imaging tests.
