The PSA Test is a blood test used primarily to screen for prostate cancer. The test measures the amount of prostate-specific antigen (PSA) in your blood. PSA is a protein produced by both cancerous and noncancerous tissue in the prostate.
Most men without prostate cancer have PSA levels under 4 nanograms per milliliter (ng/ml) of blood. The chance of having prostate cancer goes up as the PSA level goes up. Men with a PSA Level between 4 and 10 have about a 1 in 4 chance of having prostate cancer. If the PSA is more than 10, the chance of having prostate cancer is over 50%.
The Gleason system assigns grades based on how much the cancer looks like normal prostate tissue.
- Cancers with a Gleason score of 6 or less may be called well-differentiated or low-grade
- Cancers with a Gleason score of 7 may be called moderately-differentiated or intermediate-grade
- Cancers with a Gleason score of 8 through 10 may be called poorly-differentiated or high-grade
Pi-Rads (Prostate Imaging Reporting and Data System) refers to a structured reporting scheme for evaluating the prostate for prostate cancer. The score is assessed on prostate MRI. Images are obtained using a multiparametric technique including T2 weighted images, a dynamic contrast-enhanced study, and diffusion-weighted images. A score is given according to each variable. The scale is based on 1 to 5 (which is given for each lesion), with 1 being most probably benign and 5 being highly suspicious of malignancy.
- PI-RADS 1 – Highly unlikely that clinically significant cancer is present.
- PI-RADS 2 – Unlikely that clinically significant cancer is present.
- PI-RADS 3 – Uncertain whether clinically significant cancer is present.
- PI-RADS 4 – Likely that clinically significant cancer are present.
- PI-RADS 5 – Highly likely that clinically significant cancer is present.
For results of PI-RADS 4 or 5, patients should be recommended for biopsy. For results of PI-RADS 1 or 2, a recommendation for biopsy is likely inappropriate, but other factors should be considered. For results of PI-RADS 3, biopsy may be appropriate depending on patient history, local preferences and preferred standard of care.
Combines anatomic imaging in the form of T2-weighted imaging, with functional imaging, which includes primarily diffusion weighted imaging (DWI) and dynamic contrast enhancement (DCE).
The use of specific MRI sequences as well as software that generates mages from the resulting data, which uses the diffusion of water molecules to generate contrast in MR Images. It allows the mapping of the diffusion process of molecules, mainly water, in biological tissues, in vivo and non-invasively.
A measure of the magnitude of diffusion (of water molecules) within tissue and is commonly clinically calculated using MRI with diffusion weighted imaging (DWI).
A T2-weighted imaging sequence provides anatomic information about the prostate gland. It offers detailed visualizations of the prostate gland and its distinct zones. T2-weighted imaging has applications in the detection, localization and staging of prostate cancers.
During dynamic contrast-enhanced (DCE) imaging, a contrast agent is used to evaluate blood flow through the prostate. Cancerous tissue absorbs the contrast agent more quickly than healthy tissue, which is apparent on DCE images. The role of DCE imaging is secondary to T2-Weighted Imaging and DWI, but it can help to detect small, yet significant cancers missed by the other two sequences.
A test for both men and women, it allows a doctor to check the lower rectum, pelvis and lower belly for cancer and other health problems. In men the doctor can check for prostate cancer, blood in the stool or an abnormal mass in the anus or rectum.
- Age 50 or older
- Family History
- Father or Brother has had prostate cancer
- African-Americans are at a higher risk than Caucasians and Hispanics. Prostate cancer occurs less often in Asian-American and Hispanic/Latino men than non-Hispanic Caucasian men.
- Pre-Cancerous prostate changes can be a precursor to cancer
- Genetic (Chromosomal) abnormalities
- Such as a certain altered or missing gene