Miskawaan Integrative Cancer Care

Prostate Cancer Diagnosis

Prostate cancer diagnosis

Doctors use a range of methods to diagnose cancer. They also test to determine if cancer has affected other body parts different from where it started. Such a case is referred to as metastasis. 

These tests also help the doctors learn the best treatment method to adopt. 

Screening is a method used to detect most cancers. This owes to the fact that early-stage prostate cancer often doesn’t show any signs. However, advanced prostate cancers are known by the symptoms they show.

A biopsy procedure is the best method utilized to diagnose prostate cancer. A small tissue is extracted from the prostate and examined under a microscope to detect cancer cells. 

Consequently, a Gleason score is used to assess the biopsy tissue subjected to the microscope. The score, which ranges from 2 to 10, reveals the nature of the spread. A low score means that the cancer is less likely to spread.

Today’s reading will assess the options available for proper prostate cancer diagnosis.

Understanding Prostate Cancer

Prostate cancer

Prostate cancer affects the prostate, a walnut-shaped gland that is found in the male reproductive system. The cancer cells form a tumour that results in an enlarged prostate.

Prostate cancers grow slowly and can become aggressive. However, if the disease is detected earlier, treatment is possible.

Since prostate cancer doesn’t have any symptoms in the initial stages, many men die from other diseases before symptoms develop. According to the American Cancer Society, about one in eight men will suffer from the disease in their lifetime.

Prostate Cancer Risk Factors

The factors below may put you at risk of prostate cancer.

  • Obesity: Obese people have a higher risk of developing prostate cancer than people with a normal weight. Conversely, a low-fat diet slows down androgen-sensitive cancer growth, thus delaying androgens’ progression.
  • Family history: If you have a relative who’s previously diagnosed with prostate cancer, you may be at risk as well. Also, a family history of genes of breast cancer (BRCA 1 or BRCA2) accelerates your risk of prostate cancer.
  • Older age: Prostate cancers’ risk increases with age. Especially for those above 50 years (60% of cases are in those above 65). Older people who are diagnosed with this disease face unique treatment challenges.
  • Race: In the United States, African-American men have reported higher incidences of prostate cancer compared to men of Hispanic origin and native Americans. 

Prostate Cancer Screening

Cancer screening entails checking for cancer even without symptoms in healthy people. Prostate cancer screening helps to detect cancer early.

The American Cancer Society advocates screening for early detection. Prostate cancer screening should be done for men with an average risk from age 50 annually or every second year, depending on the results of the PSA blood test.

Prostate Cancer Tests

If prostate cancer is suspected, the tests below will be used alongside a physical examination to determine if a deeper diagnosis is needed:

Digital Rectal Examination

Your doctor will gently insert a gloved and lubricated finger into the rectum during a digital rectal exam. Next, he will check the base of the prostate through the bowel wall for any abnormalities (hard or soft spots or bumps).  

PSA Blood Test

A prostate-specific antigen (PSA) test checks for the levels of protein-specific antigen in your blood. 

During a PSA test, a lab technician will draw blood from a vein on your arm. Your blood sample will be screened in the laboratory for PSA levels, which are reported as nanograms of protein-specific antigen per millilitre of blood (ng/mL).

Abnormal activities in the prostate will raise PSA levels. The PSA test value will determine if a prostate biopsy is needed. 

Prostate Ultrasound and Biopsy

This stage succeeds screening. A urologist extracts small samples of the prostate tissue and scans them via a microscope.

Prostate ultrasound and biopsy

In 72 hours, the results are reported back as positive, negative or suspicious of cancer. 

Transrectal Ultrasound (TRUS)

Ultrasound involves the insertion of a small probe in the rectum. The search generates high-frequency sound waves, which are used to create photographic images or videos of the gland.

Actual Diagnosis

These are further tests to ascertain the existence of prostate cancer. A biopsy is the best way to confirm cancer presence.

Prostate Biopsy

A surgeon removes a small tissue for observation under a microscope. A TRUS is used alongside a biopsy tool to extract small slivers of prostate cells. Specimens (12 to 14 pieces) for the biopsy are taken from several areas of the prostate. 

To lower the risk of infection, some physicians resort to transperineal biopsy, which involves a TRUS, accompanied by a biopsy needle inserted into the prostate gland through the skin of the perineum. 

An MRI Fusion Biopsy Procedure synthesizes TRUS and an MRI scan. The MRI scan is first conducted to identify suspicious prostate areas. An ultrasound is then done.

The two results are analysed through computer software to produce a 3D image to better identify areas of the prostate where cancer has spread.

Prostate Cancer Stages

Prostate cancer can be staged in two different ways

Clinical Staging

Based on the Gleason score, DRE and PSA testing results, the doctor figures out whether additional scans, MRI, and x-rays are needed. If needed, more information is added to determine the clinical stage.

Pathologic Staging

Involves pathology, which precedes surgery. The lymph nodes removed are used to provide more information.

TNM Staging System

The TNM system was developed by the American Joint Committee on Cancer. It uses results from scans and tests to determine the following:

  • T(tumour) indicates the tumour’s location, size, and depth.
  • N(node) determines if the cancer cells have spread to the neighbouring lymph nodes.
  • M(metastasis) describes whether cancer cells have spread to other tissues or distant organs.

Doctors merge the TNM results with the Gleason score (grade) and PSA level to determine the stage grouping. This is then expressed in roman numerals from I to IV (most advanced) to determine the best treatment options.

Stage Grouping


Stage I

The cancer is usually on one side of the prostate. Cancer growth is very slow, and PSA levels are low. Also, cancer may not be detected during a Digital Rectal Exam (DRE). Moreover, there’s no lymph node involvement or metastasis.

Stage II

Cancer is still in the prostate. Has three substages:

  • Stage IIA: The tumour is present in one or both sides of the prostate. PSA levels are between 10-19, and Gleason’s score is ten or below
  • Stage IIB: The cancer is present in one or both sides of the prostate. PSA is below 20, and Gleason’s score is 7.
  • StageIIC: The tumour is on one or both sides of the prostate. PSA is below 20, Gleason’s score is 7-8.

Stage III

Cancer has advanced locally. The tumour is progressing and more likely to metastasize. The Gleason score and PSA levels are high

Substages include:

  • Stage IIIA: The tumour is on one or both sides. PSA is 20 or higher, and Gleason’s score is 8.
  • Stage IIIB: Cancer has metastasized outside the prostate to the neighbouring tissues. PSA can be any level and a Gleason score of 8.
  • Stage IIIC: This stage is the same as IIIB, but cancer hasn’t metastasized outside the prostate. Gleason’s score is 9 or 10.

Stage IV

Advanced prostate cancer has spread to the lymph nodes or other organs. It consists of two substages.

  • Stage IVA: cancer has spread to the lymph nodes. But it hasn’t spread to other tissues.
  • StageIVB: The tumour has spread to other parts of the body like the bone or distant lymph nodes.

Classification of Prostate Cancer

Prostate cancer types are generally classified as shown below. The information helps your doctor determine the type of cancer cells that triggered your cancer.

Type of cancer


Acinar adenocarcinoma

It grows in the inner lining of the prostate. Most common. 

Ductal adenocarcinoma

Grows in the cells that border the ducts of the prostate gland.

Urothelial cancer

It starts in the bladder and reaches out to the entire prostate gland. 

Small cell prostate cancer

It’s a type of neuroendocrine cancer that’s made up of round cells.

Squamous cell prostate cancer

Grow faster than their neuroendocrine counterpart. This is because they are formed from the flat cells that cover the prostate. 

Diagnosis and Treatment at Miskawaan Integrated Cancer Care(MICC)

At Miskawaan Integrative Cancer Care, we deliver unique treatments to every patient that maximize the outcomes of conventional oncology while minimizing the side effects.

We diagnose prostate cancer through:

  • Metavectum Tumor Therapy Test
  • Metavectum Predictive Diagnostic
  • Edim Technology (RV cancer test, Pan Tum Detect Testing)

Early detection of prostate cancer helps us employ precise prostate cancer treatment methods.

Our health care professionals are ready to take you through individualized treatment options. Contact Us Today.

Cancer Types

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