How do I get checked out?

In the UK if you are 50 years or older and a man you have a right to have a PSA test. This is done either by your Doctor or Nurse at your surgery or in hospital. In other countries this can vary.

What is a PSA Test
PSA means ( Prostate Specific Anitigen) It is a blood test where a sample of your blood is taken and sent to the pathology laboratory for testing looking for the quantity of this component in your blood.

What does this tell them?
Like all tests the PSA test is a guide, if the PSA is higher and this usually increase with age it gives your doctor an update on the overall health of your prostate gland and if you have a prostate problem. Sometimes this can be prostate cancer.

What then?
Your Doctor will refer you to a Consultant; Urologist or hospital doctor who will do further tests.

OK he finds I have prostate cancer- then what?

In the UK your hospital doctor will give you a number of treatment options for your consideration.

Full Diagnosis

The doctor will examine the patient if he has a number of the symptoms to make a diagnosis. He will examine the prostate to look specifically for enlargement of any change in the outline of the prostate. The shape of the prostate can only be examined by a rectal assessment using a DRE (digital rectal examination). After the examination, should the doctor feel that there may be a problem with the prostate, he will carry out blood tests. This test will measure levels of PSA (prostate specific antigen) within the blood stream.

Should the PSA test be elevated and symptoms are significant and there is a clinical suspicion of prostate cancer, a referral will be made to a hospital doctor. Current waiting time recommendation for receipt of an appointment is 2 weeks in the UK after referral.

At the hospital the patient will then undergo a number of tests. Usually these are: –

Ultrasound of the Prostate
 Using Ultra sound waves from a probe, the size of an index finger, inserted into the rectum gives an outline of the internal structure and outline of the prostate gland to aid diagnosis.
MRI Scan Patients are often given this scan to give an accurate view of the prostate to aid diagnosis.
Biopsy
 After being given a local anaesthetic and antibiotic tablets to prevent infection, the doctor will usually ask for biopsies to be carried out. Small needles are inserted into the ultrasound probe and then inserted through the rectum into the prostate. This should take between 10 and 20 minutes to collect biopsy samples.
Bone Scan
 Patients are also usually given a bone scan to see if the cancer has spread to their bones. This spread is called Metastases.
Review
 On receiving the results of the tests usually at a later appointment, the hospital doctor will then review the PSA levels, the biopsy results and scan and give a view to the patient on to the next step in the patient’s treatment journey.

Could my prostate cancer be inherited?

Occasionally prostate cancer has a strong inherited component and screening can be offered to ‘at risk’ relatives.
Please mention to your doctor if anybody else in your family has had prostate, breast, ovarian or bowel cancer. This is particularly relevant for men diagnosed under the age of 60.
It is hoped in the longer term that carrying out genetic tests on prostate cancers will help clinicians design specific targeted treatment plans for individual patients.
If you are concerned about any of this please contact:
The Clinical Genetics department at the Leicester Royal infirmary on 0116 258 5736.