It’s a guy thing
Chances are good that if you know several men over the age of 65, then you know someone who has been diagnosed with prostate cancer.
That’s because the lifetime risk for prostate cancer is 1 out of every 6 men.
Every year, about 186,000 men are diagnosed with prostate cancer in the U.S. alone. 28,600 men succumb from the disease every year.
Prostate or prostrate?
What is the prostate? It’s a glandular organ found in males and lies inside the pelvis, below the bladder and adjacent to the rectum. It’s function is to secrete fluid which makes up part of the ejaculate. Together, with the testes and the seminal vesicles, those three organs make up what’s produced in semen.
As a male sex gland, the prostate is very sensitive to male sex hormones, and in particular, testosterone. As a matter of fact, testosterone can stimulate the growth of normal prostate tissue, and can stimulate growth of cancer cells in the prostate as well. More on that later.
What’s this PSA business?
PSA stands for Prostate Specific Antigen. PSA is measured by a blood test.
It’s important to realize that PSA is produced by both normal prostate cells, as well as cancerous prostate cells. So every normal male with no prostate cancer should have a PSA level in the normal range, which is usually up to 4. (The unit of measurement is nanograms per milliliter, or ng/mL).
We become highly suspicious when we see PSA levels that are higher than the normal range. A high PSA level doesn’t always mean that there is prostate cancer; an infection, an enlarged prostate, or even sexual activity can influence the PSA level and make it high. But it does mean that more testing is needed.
What’s the next step after a high PSA level?
A transrectal biopsy. Ouch!
When someone has a high PSA level, then the next step is a biopsy. This is usually performed by a Urologist, and involves taking multiple small samples of prostate tissue through needle sampling, and examining them under a microscope. The pathologist examines the specimens, and can identify whether prostate cancer is present.
What’s a Gleason grade and Gleason score?
If prostate cancer is present, the pathologist will then establish a Gleason grade. This number grades how “sinister” the cancer appears under the microscope. There is data to suggest that the higher the Gleason grade, the more aggressive the prostate cancer is likely to behave.
Gleason grades are from 1 to 5, with 5 being the most aggressive appearing cancer. In prostate cancer, there can be different areas of the prostate that have different grades. Pathologists will assign two numbers– corresponding to the two most common grades they see. When you add the two numbers together, you get the Gleason score, often abbreviated GS. Gleason scores are up to 10 maximum (5+5), but it’s rare to see one below 5 (3+2) or (2+3).
Then what?
Now comes the important question– where to we go from here? And for that information, we’ll take you into the following section: Prostate Cancer: Treatment Options.