The Prostate Doctor 

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What is prostate cancer? 

  • The prostate is a gland in the male genitourinary tract.  The gland surrounds the urethra, the tube that leads from the bladder to the outside.  The prostate gland makes up fluid that becomes part of semen, the white fluid that a male produces on ejaculation.  Semen carries sperm to the outside. Cancer of the prostate occurs when a part of this gland doesn't stop growing, and the cells grow into a tumor.   Imagine a walnut with a small pea size/shaped area that becomes hardened and keeps getting bigger.  Eventually, that pea sized tumor grows


  • As this area grows larger, chances are it will grow across a blood vessel.  When this occurs, the tumor not only gets more blood supply to grow bigger, but it also enables small tiny parts of the tumor to get into the blood stream and spread to other areas in the body.  When this happens, the the small tumor pieces can then continue growing where ever they land.   Often they get stuck in small blood vessel channels in the bones. Here they grow into additional tumors.  When a tumor doesn't stop growing it is called malignant.  When a tumor spreads to other areas it is called metastatic spread.

 

  • How is this different from Benign Prostatic Hypertrophy (BPH)?  BPH is a condition where the entire gland becomes enlarged, and harder.  When this occurs, the urethral tube that takes urine from the bladder to the outside becomes crowded.  When this tube becomes crowded, it gets narrower, and urinating becomes difficult.  Imagine that your hand is holding a hose.  Imagine that you hand is the prostate gland, and the hose is your urethra.  If you squeeze the hose while water is trying to pass then it changes the stream of water coming out.  This is the same effect an enlarged prostate has on a man trying to pass urine through the urethra tube. 

 

  • How is cancer in the prostate found?   Several methods are used to find prostate cancer.  It is important to understand the limitations of each.   On physical examination the doctor places a gloved finder into the rectum.  This is called a digital rectal exam (DRE).  It is important to realize that this exam only enables the doctor to touch the back part of the prostate gland.  The front part of the prostate is not in an area that can be touched.  Therefore, if you are told by your doctor that the prostate feels normal, this is only means that the back surface feels normal.  Cancer can grow anywhere, in the front and/or the inside, where the doctor cannot feel the tumor.  The other thing to remember is that if a tumor can be felt, that means it has been present for some time.  This means that it might have already grown into the area of blood vessels.  This means that doctors need another way to check for cancer.  Recent advances in medicine, have made this possible.  A blood test called a PSA can be helpful in finding cancer in the prostate.  

If I had suspected Prostate Cancer this is where I would go

MRIProstateCancerCenter.com


  • What is PSAProstate Specific Antigen (PSA) is a blood test that looks for a protein made by the cells in the prostate gland.  If there are high levels of PSA, this means cancer might be the cause.  Small amounts of PSA are considered normal.  The problem with a PSA test is that sometimes it has a level in the middle.  This may mean cancer, or it may not.   If it is an early cancer tumor  that can't be felt, then it is very important to find out before it gets any bigger, or spreads.  

  • What happens when a PSA test is in the middle?  Doctors now can then do a biopsy of the prostate gland.  A biopsy is when a doctor takes a small sample of cells from the area of concern.  The word biopsy means to cut, or gather, a small sample.  In the case of the prostate gland this is done with a biopsy needle.  WHAT!!!  Your asking yourself how does a needle get into that gland that can't be seen, and can only be partially felt by your doctor?   You guessed it, very carefully!!!  Your doctor uses a ultrasound device near your rectum, points it towards the prostate, and looks for areas that appear harder than others.  Then your doctor will take a biopsy needle and push it towards the prostate through the skin that is between the base of you penis and your rectum.   Your doctor then uses the ultra sound to guide it towards the possible tumor.   Once the needle reaches the possible tumor, a syringe is attached to the needle and used to pull out a small sample of cells.  This is called needle aspiration. Once the sample has been taken, it is sent to the laboratory to be looked at under a microscope by another doctor called a pathologist.   If cancer cells are found then your doctor has to perform additional tests to find out what stage your cancer is.  What stage it is will determine what kind of treatment is performed.  

 

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