QUESTION: Women are told to exam their breasts for lumps, and so detect breast cancer.
It isn't that easy for men who are concerned about prostate cancer.
Can you please tell me how you do diagnose cancer of the prostate?
ANSWER: The simplest and best technique for early detection of prostate cancer is for the physician to insert a well-lubricated and gloved finger into the rectum and gently feel the prostate gland for any nodules or hard lumps, which if detected could then be followed up with additional tests. But since more than 60% of all prostate cancers go undetected until further symptoms develop, such as urinary problems or spread of the cancer, approximately 25,000 American men die from the disease each year for lack of adequate early screening.
It is the leading cause of death in black men and the third leading cause of death in all American men. These figures should convince even the most squeamish male to have regular yearly screening exams after the age of 40, for prostate cancer is rare in men under 50 years.
The fact that an estimated 36% or so male readers of a popular health magazine over 40 years of age had never had a rectal exam indicates their aversion to what should be a relatively uncomfortable but painless procedure. Other tests such as measuring the serum acid phosphatase are widely and readily available.
This blood enzyme test has an accuracy of 84%, and can be used to confirm a diagnosis made by physical examination. Less widely used tests use ultrasound, computerized tomography (CT), and magnetic resonance imaging (MRI), but the last two are not sensitive enough to pick up early tumors, and are relatively expensive. If a nodule is found during the finger exam and the serum alkaline phosphatase is positive, to clinch the diagnosis your physician may insert a very fine hairlike needle in the nodule to remove a sample of cells which he can be stained and quickly examined under a microscope.
This exam needs no anesthesia.
Interpretation of the removed cells requires an experienced pathologist. The digital rectal exam, however, remains the cornerstone of screening, since it is highly accurate, cost-effective and takes only a few minutes.
The technique detects all but very small or hidden cancers which occur in 5% to 21% of cases and are revealed only after the prostate has been removed for what appeared to be benign enlargement.
The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician.
Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.
