THE "NEW" PROSTATE CANCER INFOLINK

Contents of This Section

• For newly diagnosed patients …
• Prostate cancer screening and early detection (and video presentation)
  • The role of PSA today (in prostate cancer diagnosis)
  • Is regular prostate cancer testing appropriate for everyone?
  • The PLCO trial
  • The ERSPC trial
  • The Tyrol, Austria and King County, Washington screening studies
  • Risk-related screening
  • For men over 75: The Iowa Prostate Cancer Consensus
• Signs and symptoms of prostate cancer
• Digital rectal examination or DRE (and video presentation)
• Prostate specific antigen testing
  • Different PSA tests and how they can be used
  • PSA velocity: is it important to prostate cancer risk?
• Diagnosis: an introduction
• Prostate biopsy: how it’s done and what’s involved (and two video presentations)
• The biopsy results: how to read them and what they mean
• What on Earth is PIN?
• That’s not what ASAP stands for! Is it?
• Other important tests
  • The prostatic acid phosphatase or PAP test
  • MRI, CT, and other imaging tests
  • Bone scans
  • Evolving tests for new markers
• The spouse or partner’s roles and perspective

Summary Overview

To properly nail a diagnosis of prostate cancer requires a prostate biopsy.

The problem physicians and patients have been struggling with for years is who should get a biopsy?

Almost every man who lives into his 90s has a very high probability that at least a small focus of cancer will be found in his prostate. But it is equally true that for large numbers of older men, such “latent” (effectively clinically inactive or “indolent”) prostate cancer may have no clinical significance. To date we still have no good answer to the conundrum so elegantly phrased many years ago by Willet F. Whitmore, Jr., MD, when he asked:

Is a cure possible in those for whom it is necessary, and is it necessary for those in whom it is possible?

It is a sad commentary on the unkindness of this disease that Dr. Whitmore himself, who may have been the greatest urologic cancer surgeon of his generation, went on to die of prostate cancer at the age of 78.

In this section we will do everything we can to try and give you a full appreciation of the critical nature of the question, “Who should get a biopsy?” You may also want to look carefully in information about risks for prostate cancer. Your individual risk will impact the appropriateness of a biopsy, depending on the signals that you may be at risk.

Content on this page last reviewed and updated March 27, 2011.