Prostate cancer is a malignancy of the prostate gland, an organ that forms a ring around the urethra, near its connection to the bladder. The urethra is the tube that carries urine from the bladder to the outside of the body.

Prostate cancer is the most common cancer affecting men. Every year, more than 200,000 American men are diagnosed with prostate cancer. Over the last 15 years, the increasing use of prostate cancer screening with blood tests of prostate-specific antigen (PSA) has led to more men being diagnosed at an early stage, when the cancer is still limited to the prostate gland and is highly curable. There are three standard approaches to treating early prostate cancer: surgical removal of the prostate gland, radiation therapy with or without hormone therapy, and "active surveillance".

However, approximately 15 to 20 percent of newly diagnosed prostate cancers are advanced by the time they are detected, meaning that the cancer has spread outside the prostate gland (called locally advanced prostate cancer) and/or involved the lymph nodes or other organs (called metastatic prostate cancer).

Cases of advanced prostate cancer can also occur in men who are initially treated for localized disease and whose prostate cancer then recurs (commonly referred to as a relapse). Sometimes recurrent disease is amenable to radiation therapy or surgery, but hormone therapy or chemotherapy can also be used.

When a diagnosis of prostate cancer is made, necessary tests are done to determine the “stage” of your cancer. Treatment for prostate cancer depends upon its stage, which indicates how far the cancer has spread within the body. Prostate cancer is usually staged according to the system known as TNM (tumor, node, metastasis), in which the cancer is characterized by its extent within the prostate gland itself (tumor or T stage), whether the lymph nodes in the region are involved with cancer (node or N stage), and whether the cancer has metastasized to other parts of the body (metastasis or M stage).

We have listed various tests, items, and consults you may need to determine your treatment plan:

1. Digital rectal exam. The urologist will need to feel the prostate gland on physical exam.
2. PSA (prostate specific antigen). This blood test helps guide and follow treatment.
3. Prostate biopsy. This is done to confirm and diagnose cancer.
4. Gleason score. This tells us the aggressiveness of the tumor, based on the biopsy specimen.
5. CT scan of the abdomen/pelvis. This type of X-ray looks at the prostate and lymph nodes to evaluate for spread cancer.
6. Bone scan. This type of X-ray evaluates for prostate cancer in the bone.
7. Blood tests. Your blood will be drawn to evaluate your blood counts, kidney function, and liver function (CBC—complete blood count and CMP—comprehensive metabolic panel).
8. Urology consult. Urologists are surgical experts in prostate cancer and can administer hormone treatments as well.
9. Radiation oncology consult. Radiation therapy can play a large role in treating localized prosate cancer and providing palliation for advanced cases.
10. Medical oncology consult. Medical oncologists are experts in prostate cancer and can administer chemotherapy or hormone treatments. Clinical trials may also be available as additional treatment options.

Websites:

www.cancer.gov/cancer_information/cancer_type/prostate

www.mayoclinic.com/health/prostate-cancer/PT99999

Resources:
www.uptodate.com