If you or a loved one have recently been diagnosed with prostate cancer, you will likely have questions about treatment and what to expect. You may also want to know more about the diagnosis process.
Prostate cancer diagnosis and treatment usually incorporate various scans in order to find and effectively destroy cancerous cells, as well as monitoring for recurrence. The best scan for prostate cancer in your case will depend on your personal circumstances and what you and your doctor have agreed on, but there are some common approaches.
Scans for Prostate Cancer Diagnosis
Prostate cancer doesn’t usually come with symptoms, which means screening is extremely important in order to catch it early and decide on treatment. We use a variety of tests and scans to determine whether prostate cancer is present and how it’s affecting the body.
PSA Blood Test
Prostate-specific antigen, or PSA, is a protein made by cells in the prostate gland. It’s generally found in semen, but a small amount is also present in the blood. Testing PSA is useful because higher PSA levels may indicate a higher likelihood of prostate cancer.
Even if you have already been diagnosed with prostate cancer, your doctor may still want you to get a PSA blood test to determine what stage of cancer you have and what sort of treatment would be most effective. PSA levels can also indicate how well treatment is going.
PSMA PET Scan
Many of our patients have had prostate-specific membrane antigen positron emission tomography (PSMA PET) scans. These imaging tests use a radioactive substance to detect prostate cancer in the body and can be used not only to see the presence of prostate cancer, but also whether it has spread. After injection, the radioactive substance specifically targets and attaches itself to PSMA, which is a protein secreted by prostate cancer. The patient then receives a CT or MRI scan, which highlights the locations where PSMA is the highest. A radiologist closely reviews the scans in the areas with the highest concentration of PSMA for evidence of prostate cancer.
Prostate Biopsy
If initial tests suggest that you might have prostate cancer, your doctor will probably recommend a prostate biopsy. This test involves removing a small sample of tissue from the prostate for further testing. Your doctor may also use imaging tests such as a transrectal ultrasound (TRUS) or MRI to get a better view of the prostate. The procedure takes about ten minutes and is usually done in the doctor’s office.
Genetic Testing
If you are diagnosed with prostate cancer, your doctor might suggest certain genetic tests of the cancer cells to help determine the best treatment options for you. For example, if the cancer hasn’t spread, a molecular or genomic test might help determine when and how quickly that will happen. Specific gene and protein changes can also show if targeted therapy drugs might be helpful during treatment.
Scans for Prostate Cancer Treatment
It’s important for your doctor to know the size and location of any cancerous tumors when determining treatment. Scans can also show how various procedures are affecting the cancer, as well as if it has spread anywhere else.
One of the best ways to do this is to use scans to collect information throughout the diagnosis and treatment processes.
Transrectal Ultrasound (TRUS)
Transrectal ultrasounds, or TRUS, work a bit like radar. A probe inserted into the rectum lets off sound waves that a computer turns into a black-and-white image of the prostate. The process is generally not painful and only takes about ten minutes.
TRUS can be used to get a better look at any potential problem areas. It may also be used in combination with other scans, such as gathering more data based on a PSA blood test or as part of a prostate biopsy.
Magnetic Resonance Imaging (MRI)
Magnetic Resonance Imaging scans, or MRIs, are used as part of many medical procedures. These scans use radio waves and strong magnets to create detailed images of soft tissue in the body. This can be helpful for getting a good look at the state of the prostate and nearby areas. MRIs sometimes involve using a contrast material called gladolinium to make it easier to see the smaller details.
When it comes to diagnosing and treating prostate cancer, MRI scans can help your doctor decide whether and how to proceed with a prostate biopsy. They may also be used during the biopsy itself to guide the process.
Bone Scan
If it spreads, prostate cancer often affects the bones next. If this seems like a possibility for you, your doctor may recommend a bone scan. This scan involves injecting a small amount of low-level radioactive material that settles into any damaged areas of the bones. Your doctor will use a special camera to detect the radioactivity and create a full picture of your skeleton.
While bone damage might suggest the spread of cancer, there are many other possible causes, too. This means your doctor is likely to suggest other tests as well.
Positron Emission Tomography (PET) Scan
A Positron Emission Tomography or PET scan works a bit like a bone scan in that it involves injecting the patient with a small amount of radioactive substance, called a tracer, that a special camera then detects once it’s in the body. However, unlike bone scans, PET scans are primarily used to find cancer cells.
The pictures produced from a PET scan aren’t as detailed as MRI or CT scan images, but they can be used in more areas of the body, making them a useful way to track cancer that has spread. There are also many new PET scan technologies that could make it more effective for finding and treating prostate cancer.
Computed Tomography (CT) Scan
Computed Tomography or CT scans use x-rays to create detailed, cross-sectional images of the body. They aren’t used as much for recently diagnosed prostate cancer, but they can be helpful for determining if the cancer has spread to nearby lymph nodes.
Prostate Cancer Treatment Options
At Integrated Cancer Care, we provide personalized care to our patients using a compassionate, multidisciplinary approach that takes your needs into account. When treating prostate cancer, we make sure to answer your questions about possible procedures and help you understand what to expect with each type of therapy.
Radiation therapy is commonly used to treat prostate cancer. Depending on factors such as scans and your personal health status, our radiation oncologists will likely use External Beam Radiation Therapy, or EBRT; internal radiation, or brachytherapy; or radiopharmaceuticals for treatment.
External Beam Radiation Therapy (EBRT)
External beam radiation, or EBRT, uses high-energy x-rays to target cancer cells in and around the prostate. This approach minimizes the chances of cancer cells spreading to other parts of the body because it focuses on destroying the genetic material within the cells, which eliminates their ability to grow and divide. The narrow focus of EBRT also helps preserve the surrounding healthy tissue.
During EBRT, the machine does not make contact with your body. The treatment can also be done on an outpatient basis.
Internal Radiation (Brachytherapy)
Internal radiation, or brachytherapy, delivers radiation from inside of the body. Like EBRT, it focuses the radiation only on the cancer cells, which minimizes side effects and helps keep surrounding tissue healthy. However, brachytherapy is more invasive because it involves placing a temporary or permanent implant into your body that releases small amounts of radiation over a specific amount of time. While EBRT may be administered all in one appointment, brachytherapy is a longer-term process.
Radiopharmaceuticals
Some patients may also be treated using radiopharmaceuticals. These intravenous drugs deliver radiation therapy directly to cancer cells from within the body. If your prostate cancer has already received treatment and still spread to other locations, this may be another option.
Find Out More
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