Archive for the ‘prostate gland’ Category

Don’t Fight the Nite With Prostate Enlargement

February 6, 2017

 

Nearly every man over the age of 50 experiences symptoms of prostate gland enlargement.  The symptoms are going to the bath room frequently, poor force of the urine stream, dribbling after urination and perhaps the most troublesome of all is getting up at night to urinate.  Every night, between 12 and 15 million men in the U.S. are likely to have loss of sleep because of an enlarged prostate gland.  This article will discuss the purpose of the prostate gland and what treatment options are available for this common condition.

The prostate gland is typically the size and shape of a walnut and is located in the lower part of the pelvis, below the bladder. It envelops the urethra, the tube through which urine flows from the bladder out of the body. When the prostate gland grows bigger – which happens to virtually every man as he ages – it can compress the urethra and make it difficult to pass urine.

Benign enlargement of the prostate gland does not cause prostate cancer or affect a man’s ability to have, but if the symptoms bother you, seek treatment. If left untreated, BPH can lead to urinary retention and cause bladder, urinary tract and kidney problems.

Coping Techniques.

Try behavioral changesPerhaps the easiest suggestion is limiting your fluid intake at night and not drinking anything for two hours before bedtime.  I also caution to decrease those foods and beverages that are diuretics (and will therefore prompt you to urinate more), such as coffee, caffeinated tea, herbal tea, lemon juice, chocolate, pineapple, grapes and cherries.

If those behavioral changes don’t help much, consider medication. A change in habits will help some but not all men with BPH, and for those whose symptoms aren’t relieved, medication is an option.  The most commonly used medications are alpha blockers, (Flomax) which can relax the muscle at the base of the bladder and the prostate, and 5 alpha reductase inhibitors, (Proscar) which can, over a period of months, shrink the prostate.  Like nearly all medications, they do have side effects.  For example, alpha blockers can cause the man taking them to faint and by decreasing his blood pressure when moving from laying down to standing upright quickly.  Alpha blockers also can cause sexual side effects like decreasing the volume of the ejaculate or having no ejaculation at all.  The 5 alpha reductase inhibitors can cause sexual dysfunction, such as impotence. Some physicians are also prescribing tadalafil, commonly known by its brand name Cialis, which is often marketed as a drug that treats erectile dysfunction, but can also help to relax the muscles in the prostate gland and thus relieve urinary symptoms.

If behavioral changes and medication don’t work or cease to be effective, surgical procedures are an option.  Until recently the two most common procedures are a transurethral resection or TURP, in which an instrument is inserted up the urethra to cut out the part of the prostate that’s blocking urine flow, and a laser procedure, which vaporizes the tissue obstructing the urethra. Both procedures are typically effective but carry the risk of side effects such as erectile dysfunction. Other, newer procedures, such as the UroLift System, in which a urologist places tiny implants in the prostate to increase the opening of the urethra and allow for greater urine flow.  This procedure can be accomplished in the outpatient or ambulatory treatment center or even in the doctor’s office.  The advantage of the UroLift is that there are no sexual side effects and the results are noted almost immediately after the procedure.

Bottom Line:  The enlarged prostate gland affects millions of American men.  It significantly impacts a man’s quality of life.  Help is available.  Speak to your doctor.

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The Care and Feeding of the Enlarged Prostate Gland

October 21, 2016

If you are a man, then you have a prostate gland.  If you have a prostate gland, then you are likely to be one of the 14 million American men who experience bothersome symptoms beginning around age 50.  This article will discuss the diagnosis of the enlarged prostate gland and what are some of the available treatment options that can reduce the symptoms associated with this common condition.  It is a walnut sized organ at the base of the bladder and surrounds the urethra or tube that is in the penis and transports urine from the bladder to the outside of the body.  It is common and even normal for the prostate gland to become enlarged as a man ages. Though the prostate continues to grow during most of a man’s life, the enlargement doesn’t usually cause problems until middle age or around 50. BPH rarely causes symptoms before age 40, but more than half of men in their sixties and as many as 90 percent in their seventies and eighties have symptoms of BPH.

The prostate gland encircles the urethra like a donut, so problems with urination can occur if the gland restricts urine flow through the urethra. As the prostate enlarges, the layer of tissue surrounding it stops it from expanding, causing the gland to press against the urethra like a clamp on a garden hose.

The following changes occur over a period of time.

  • The bladder wall becomes thicker and will contract without the owner’s permission causing urgency of urination.
  • The bladder begins to contract even when it contains small amounts of urine, causing more frequent urination.
  • Eventually, the bladder weakens and loses the ability to empty itself. Urine remains in the bladder.

The narrowing of the urethra and partial emptying of the bladder cause many of the problems associated with BPH.

Some problems associated with BPH are

  • Urinating more often during the day
  • Need to urinate frequently during the night
  • Urinary urgency, which means the urge to urinate is so strong and sudden, you may not make it to the toilet in time and soil your clothing-very embarrassing!
  • The urine stream is slow to start
  • Dribbling after urination
  • A sensation that the bladder isn’t emptied after urination
  • Lack of force to the urine flow, which makes aiming more difficult
  • The sensation of needing to go again a few minutes after urinating

Diagnoses

You may first notice symptoms of BPH yourself, or your doctor may find that your prostate is enlarged during a routine check-up. The doctor can determine the size of the prostate gland during a physical examination.

The diagnosis is made with several of the following tests:

Symptom Score

This is a brief questionnaire that provides a numerical value to the symptoms associated with urination.  The higher the score (maximum is 25), the more symptoms a man has and the more likely he will want to have treatment for relief of his symptoms.

Urinalysis

A urine sample is taken to look for signs of blood and infection.

Digital Rectal Examination (DRE)

Your doctor inserts a gloved finger into the rectum to feel the condition of the prostate that lies close to the rectal wall. If your doctor feels something suspicious such as a lump or bump, further tests will be carried out. Other tests are needed to enable a more accurate diagnosis. 

Prostate Specific Antigen (PSA) Test

A blood sample is taken by your doctor to check for prostate specific antigen (PSA), which is produced by the prostate and is increased by cellular abnormalities within the prostate.

As men get older the prostate gland grows and so the PSA is likely to rise. A high PSA may indicate some type of prostate disease. The level can be raised due to inflammation of the prostate (Prostatitis) and enlargement of the prostate gland (Benign Prostatic Hyperplasia or BPH).

Urine flow rate

This test consists of a man urinating in private over a funnel which measures the volume of urine and the time that it takes to empty the bladder.  The urine flow rate is expressed in milliliters per second.  Normal is greater than 15 ml\second.

Urodynamics

Sometimes the doctor will ask a patient to urinate into a special device that measures how quickly the urine is flowing. A reduced flow often suggests BPH.

Imaging studies

The ultrasound examination evaluates the size of the prostate gland which often determines the treatment option which is best for your situation.  It is a painless examination consisting of the insertion of a small pencil-size probe into the rectum and uses sound waves to determine the appropriate treatment for prostate gland enlargement.

Cystoscopy

In this exam, the doctor inserts a small tube through the opening of the urethra in the penis. This procedure is done after a solution numbs the inside of the penis so all sensation is lost. The tube, called a cystoscope, contains a lens and a light system, which help the doctor see the inside of the urethra and the bladder. This test allows the doctor to determine the size of the gland and identify the location and degree of the obstruction.

Treatment options

  1. Watchful waiting-If the person has BPH but is not bothered by the symptoms, the patient and the doctor may decide to simply wait and monitor the condition regularly. This option requires regular check-ups with the doctor – usually once a year – to see if the condition is getting any worse.
  1. Drug therapyYour doctor may advise drug therapy which aims at shrinking the enlarged prostate. The doctor will select the medication that best suits the condition, keeping in mind the person’s general health condition, medical history, medications taken for other conditions and quality of life considerations.
  1. Minimally invasive treatments-The prostatic urethral lift or UroLift is an implant of several polyester sutures connected by two small metallic tabs that opens the prostate gland located in the urethra and improves the flow of urine thus decreasing the symptoms of the enlarged prostate gland. UroLift has been approved by the FDA to relieve the symptoms of the enlarged prostate gland. There have been nearly xx thousand of men who have had the treatment which reports favorable results up to 4 years. Most insurance companies will now pay for the UroLift procedure 
  1. Surgery-Surgery is another option for the treatment of BPH. The most common type of surgery for BPH is TURP (Trans Urethral Resection of the Prostate). This procedure requires an admission to the hospital, a general anesthesia, a urinary catheter for several days, and the risk of sexual problems afterwards.

Bottom Line:  Nearly all men will experience the problems associated with the enlarged prostate gland.  The enlarged prostate gland impacts a man’s quality of life.  Help is available and nearly all men can be helped.  If you have symptoms associated with urination, speak to your doctor.

Don’t Beat the Band to Treat the Enlarged Prostrate Gland

October 21, 2016

The prostate is just a walnut sized gland that forms a part of the male reproductive system. The gland is constructed of two lobes, or areas, surrounded by an outer layer of tissue. For reasons not entirely understood, the prostate gland becomes enlarged, causes problems with urination, and affects a man’s quality of life.  That may be the bad news.  The good news is that there are ways to treat it.

 

The prostate can be found in front of the rectum and just beneath the urinary bladder, where urine is stored. The prostate also encompasses the urethra, the duct by which urine passes out from the body. For most men, the nightly bathroom runs can be the very first indication of an enlarged prostate. Other symptoms might include problem beginning a flow of urine, leaking or dribbling.

 

During the early stage of prostate enlargement, the urinary bladder muscle becomes thicker and forces pee through the narrow urethra by contracting more strongly. Like grey hair, an enlarged prostate is just a natural byproduct of getting older, doctors say.

Although it is just not known why only some males develop an enlarged prostate, it is clear that increasing age is the primary risk factor. The problem is, the nightly bathroom runs can be frequent, finally edging their way into the day routine. I recommend seeing your doctor if you develop urinary difficulties because of an enlarged prostate.

 

Benign prostatic hypertrophy is a non-cancerous enhancement of the prostate gland, often found in men over the age of fifty. Problem in passing urine or pain when passing urine, a burning or stinging feeling when passing urine, strong, regular urge to pass urine, even when there is just a small amount of urine are the signs of benign prostatic hypertrophy.

 

Treatment for an enlarged prostate is dependent upon the symptoms and signs and their severity. In case you have significant problems, like urinary bleeding, persistent bladder infections, urinary bladder and kidney harm, your physician will likely recommend treatment.

 

In case your prostate is enlarged, but your symptoms are not too bothersome, treatment might not be necessary. This is referred to as watchful waiting.  If you and your doctor select this option, you will be asked to return about once a year for a symptom check, a prostate exam and a PSA test or prostate specific antigen test which is a screen test for prostate cancer in men between the ages of 50 and 75.

 

There are two kinds of medication that help to control the signs of an enlarged prostate, they are alpha blockers and alpha reductase Inhibitors.

The alpha blockers work by calming the muscles at the neck of the urinary bladder making urination easier. Alpha reductase inhibitors work be actually shrinking the size of the prostate gland.  An enlarged prostate now is just easier to treat if the treatment begins early. These medications have side effects including reducing the volume of the ejaculate at the time of sexual intimacy.  The alpha blockers also affect the ability to have cataract surgery which is very common in older men.  Finally, the drugs must be taken for the rest of man’s life.

 

Now there are minimally invasive treatments such as lasers, prostatic urethral implants or UroLift to open the prostate to allow an improved flow of urine from the bladder to the outside of your body, and the use of steam or water vapor to heat the prostate tissue to reduce its size and affect urine flow.

 

Finally, there are surgical procedures to remove the prostate tissue.  The most common is the transurethral resection of the prostate or TURP.  These operations require admission to the hospital, a general anesthesia so the patient doesn’t experience any pain, the use of a catheter for a few days, and several weeks or moths to return to normal activity.

 

Your doctor will explain the different treatments and which might be best for your situation.

 

FAQs on the Enlarged Prostate

October 21, 2016

 

What is BPH?
 Benign prostatic hyperplasia is commonly known as enlarged prostate. BPH is a non-cancerous condition in which prostate cells grow, enlarging the gland and causing it to squeeze the urethra. A variety of symptoms may result, including difficult, frequent or urgent urination.

When Should I Seek BPH Treatment?
If you are experiencing BPH symptoms that are affecting your quality of life, such as losing sleep because you need to wake during the night to urinate, you are unable to urinate, you are unable to delay urination, have hesitancy, or a weak urine stream, check with your urologist to discuss if it is time to seek treatment.

BPH is not cancerous and is not life threatening, but it does create bothersome symptoms can significantly impact quality of life.

What Are the Long Term Risks of BPH?

If left untreated, BPH can progress and cause subsequent medical issues. When the bladder does not empty completely, you become at risk for developing urinary tract infections. Other serious problems can also develop over time, including bladder stones, blood in the urine (hematuria), incontinence, or urinary retention. In rare cases, bladder and/or kidney damage can develop from BPH.

What are the Treatment Options?

Based on the AUA Guidelines for the treatment of BPH, there are four recommended treatment options: Watchful Waiting, medications, in-office therapy, and surgery.

Are In-Office Therapies Safe?

Yes, these treatments are safe. UroLift has been cleared by the FDA to treat BPH. In-Office BPH Treatments are associated with few side effects and adverse events.

Are In-Office Therapies Effective?

Based on clinical studies, in office procedures is proven to be a safe, effective and durable option for BPH with very few side effects.

Are In-Office Therapies Covered By Insurance?

Medicare and many commercial insurance plans provide coverage for the UroLift procedure. Ask your doctor’s office to assist you by providing the information your insurance plan may require.

Do In-Office Therapies Hurt?

Some men describe the UroLift as causing some discomfort, while most men report no discomfort at all.

Will I need a catheter after the treatment?

Most patients will not need a catheter after the procedure.

Can I go home right after the procedure?
 Yes. You should arrange for someone to drive you home because you may have been given some medication to help you relax during the procedure. Your urologist will give you post-treatment instructions and prescriptions and explain the recovery period to you.

Bottom Line: BPH is a common problem and effective treatments are available.  For more answers, speak to your physician.

Complications of the Large Prostate Gland

October 21, 2016

 

The most common condition affecting millions of middle age American men is benign enlargement of the prostate gland.  This is called benign prostatic hyperplasia or BPH, which is a non-cancerous enlargement of the prostate. For reasons not entirely known, the prostate increases in size around age 50.  As the prostate gland grows, the gland compresses the urethra, which is the tube that transports urine from the bladder to the outside of the body.

Over time, the growth causes the urethra to become so compressed that it becomes difficult for men to empty the bladder.   The symptoms associated with enlarged prostate gland include frequency of urination, urgency of urination, dribbling after urination and even the complete inability to urinate or allowing only a small amount of urine to exit the bladder.

Bladder stones are formed when crystals inside the bladder collect together and harden to form a stone.  They often occur when the bladder is not fully emptying, so the urine that is left behind remains in the bladder for long time and coalesce and form stones.

Symptoms of bladder stones include frequent urination throughout the day, lower abdominal pain, a burning sensation when urinating, urine that appears cloudy or contains blood, and urgency of urination.

Urinary retention is the inability to fully empty your bladder. Acute urinary retention is a medical emergency, so it does require immediate medical attention.

There are two main types of urinary retention.  If there is an obstruction such as a bladder or kidney stone, then urine cannot properly be released, resulting in urine remaining in the bladder after urination. In this case, urinary retention can be life threatening, and you will require immediate medical intervention and the insertion of a catheter to relieve the blockage.

The most common cause of acute urinary retention is the enlarged prostate which compresses the urethra or the tube from the bladder that transports urine from the bladder to the outside of the body.

Non-obstructive urinary retention is caused by the weakening of the bladder muscles or nerve problems disrupting the communication between the bladder and the brain. Causes of non-obstructive urinary retention include stroke, pelvic injury or trauma, nerve diseases, impaired muscle or nerve function, and spinal cord injury that affects the nerves to the bladder.

Chronic urinary retention mainly affects men as a result of prostate enlargement. Although the condition is not life threatening, it can lead to permanent kidney damage. In chronic urinary retention, a man is unable to fully void their bladder, so urine stays within the bladder, increasing the risk of urinary tract infections.

Symptoms of chronic urinary retention include urinary frequency, urgency and hesitancy, nighttime urination, symptoms similar to a urinary tract infection, and lethargy and emotional irritability.

Urinary tract infections are often associated with urinary retention. Symptoms include cloudy or foul-smelling urine, blood in urine, difficulty urinating, pain while urinating, nausea, vomiting, shaking and chills, and fever.

Hematuria, or blood in urine, is frequently a benign condition, but there may be a risk of a more serious condition, too. For men with documented blood in the urine which is confirmed by a urine examination, you will will need some additional testing such as urine culture, a radiologic examination of the kidneys, and a cystoscopy or a look in the bladder with a lighted tube.

As the bladder retains urine, it continues to stretch. Excess stretching weakens the bladder muscles, making it impossible for the bladder to contract.  If this is left untreated, then permanent damage to the bladder muscle will occur and even if the obstruction is relieved the bladder muscle cannot contract and the man may be left with a permanent urinary catheter or may have to catherize himself several times a day.

Bottom Line: Every man over age 50 should see his doctor every year to check his prostate and to obtain a PSA blood test which is a screening test for prostate cancer.  Nearly every man can be treated with either medications or minimally invasive procedures that can often be done in the doctor’s office.

Smelling Prostate Cancer

February 19, 2016

Prostate cancer is the most common cancer in older men with nearly one quarter of a million new cases discovered each year.  It is the second most cause of death in men with over 25,000 deaths each year.  Now there is a new diagnostic device that can detect prostate cancer in men’s urine.

A new device, Odoreader, was developed in the UK which can be helpful in disgnosing prostate cancer by identifying the unique odor in the urine of men with prostate cancer.

The researchers looked at a total of 155 men of which 58 had been diagnosed with prostate cancer by evaluating their urine with the Odoreader. The researchers found that Odoreader was able to successfully identify patterns of volatile compounds from urine samples, and detect those that indicate cancer.

Unfortunately at the present time there is no accurate test for prostate cancer. The standard used to day is the PSA blood test. The PSA test is not specific for prostate cancer and may also detect other prostate conditions such as benign enlargement of the prostate as well as prostate infections. The PSA test indicators can sometimes result in unnecessary biopsies, resulting in psychological toll, risk of infection from the procedure and even sometimes missing cancer cases. This new testing procedure can detect cancer in a non-invasive way by smelling the disease in men’s urine.

The Odoreader could pave the pathway for a new detection technique of prostate cancer, making invasive diagnostic procedures like a prostate biopsy less necessary and potentially saving the lives of many men who fight the disease.

Bottom Line: Prostate cancer is a prevalent medical problem affecting thousands of American men.  Now there is a new technique for the diagnosis of this disease which is non-invasive, accurate, and will help men avoid unnecessary diagnostic studies and perhaps unnecessary surgery.

Preventive Health For All Men

January 18, 2016

Do you know that most men spend more time taking care of their cars or planning a vacation than they do taking care of their health?  In the U.S., women live 5-7 years longer than men.  I believe one of the reasons is that women seek out regular medical care throughout their entire lives.  They see a obstetrician during child bearing years; they get regular mammograms; they obtain routine PAP smears and other preventive health measures for their entire lives.  Men, on the other hand, stop seeing a doctor around age 18 and never see the inside of a medical office until middle age.  During that time they can have high blood pressure, elevated cholesterol levels, diabetes, and prostate diseases.

But there are some things men, in particular, should keep in mind when it comes to maintaining their health:

Heart disease and cholesterol

According to the Centers for Disease Control and Prevention, about 200,000 people die each year from preventable heart disease and strokes, with men being significantly more at risk than women.

Men should begin screenings for these issues in their mid-30s.

Annual health examinations should begin at around age 50.  This should include a test for anemia, a cholesterol level, a chest x-ray if the man is a smoker, a PSA test for prostate cancer, and a blood pressure determination.

For those men with an elevated cholesterol level, they can lower the level by adhereing to  a healthy diet consisting less heavy in red meats and carbohydrates, and limiting alcohol consumption, i.e., 2 drinks\day. Men of all ages should also continue to stay physically active by incorporating aerobic activities, i.e., any activity that increases the heart rate for 20 minutes 3-4 times a week, into their lifestyle, as well as strength training.

Prostate health

There is some debate among health care professionals about when men should begin screening for prostate cancer. The U.S. Preventive Services Task Force and the CDC recommend against screening unless men begin experiencing the symptoms associated with prostate cancer. These include frequent urination, especially at night, pain during urination and difficulty fully emptying the bladder.

Prostate screening can begin earlier in life, around age 40, if there is a high risk for prostate cancer, such as family history, or bothersome lower urinary tract symptoms.

Testosterone

As men age, lowering testosterone levels can become another area men should monitor.  Significantly low testosterone levels can predispose a man to low bone mineral density with subsequent bone fractures, erectile dysfunction (impotence) and low energy levels.

Testing for testosterone levels is done through a blood test.

Bottom Line: these are the minimal preventive care that all men should consider around age 30-40.  Remember if it ain’t broke don’t fix it, may apply to your car, but not to your body.  You need to take preventive measures with your body just as you do with your automobile.

Testosterone and the Prostate Gland

December 14, 2015

Many men suffer from hormone deficiency with symptoms of loss of libido, erectile dysfunction, loss of energy, loss of muscle and bone mass, and even depression.  These men with low levels of testosterone are helped with hormone replacement therapy using either injecitons of testosterone, topical tesotserone gels, or pellets of testosterone inserted under the skin.  Some men are concerend that the use of testosterone will icrease the risk of prostate cancer or cause them to have more urinary symptoms.

A recent review found little evidence to support that urinary symptoms would worsen as a result of using testosterone replacement therapy (TRT).

Furthermore, although the Endocrine Society and other associations have suggested severe LUTS as a contraindication to TRT treatment, investigators found little evidence to support it after reviewing the limited research.

The study showed that men with mild urinary symptoms such as getting up at night or having dribbling after urination experienced either no change or an improvement in their symptoms following TRT.

It is of interest that patients with metabolic syndrome (diabetes, hypertension, high cholesterol, and increase in abdominal fat) experienced symptomatic improvement after TRT.  The study even pointed out that men with the metabolic syndrome who received testosterone replacement therapy also had improvement in the underlying metabolic syndrome, i.e., lower blood pressure, lower cholesterol levels, and improvement in their control of their diabetes.

Bottom Line:  Testosterone is safe for men with mild urinary symptoms and may even help with reduction in urinary symptoms in some men.

Source:

Kathrins M, Doersch K, Nimeh T, Canto A, Niederberger C, and Seftel A. The Relationship Between Testosterone Replacement Therapy and Lower Urinary Tract Symptoms: A Systematic Review. Urology S0090-4295(15)01053-3. doi:10.1016/j.urology.2015.11.006.

Prostate Biopsy Negative? What’s Next?

November 21, 2015

There are over 1 million men who have a prostate biopsy each year.  Many of the biopsies are negative.  What can a man do who has an elevated PSA level and a negative biopsy to be certain that he doesn’t have prostate cancer and avoid having a second biopsy?

Lots of controversy surrounds the standard PSA (prostate-specific antigen) screening test for prostate cancer, which is unreliable and not specific for the disease. This uncertainty has prompted many men to ask, “Is there a better test for PSA?” Fortunately, there are options which, while they don’t replace the current PSA test, can provide significantly more reliable, actionable information.

The PSA test involves a blood draw and measuring the level of the blood protein, prostate specific antigen. Currently, men whose PSA test levels are between 4 ng/mL and 10 ng/mL typically are told they should consider getting a prostate biopsy. However, an elevated PSA can be caused by many different benign conditions such as benign enlargement of the prostate gland, a prostate infection or simply lifestyle habits, which means a biopsy would be an unnecessary invasive procedure.

Why we need more accurate testing?

Approximately 1.3 million prostate biopsies are performed annually, and less than one third of them reveal cancer. While that sounds like good news on one hand, on the other hand it means that two thirds of those biopsies may not have been necessary and/or these men have negative biopsy results but other clinical risk factors for prostate cancer such as a family member who has prostate cancer or being an African-American man who have a slightly greater risk for prostate cancer than a Caucasian man.

If you have been in this situation, you probably know how frustrating and confusing it can be. What should you do? Have a repeat biopsy or choose to have more tests? The uncertainty of having a hidden prostate cancer can lead men to get repeat biopsies, which can be associated with an increased risk of infection, hospitalization, emotional trauma, and significant costs.

Fortunately, some progress is being made in the realm of better testing for prostate cancer and in determining whether a prostate biopsy is necessary. In this blog I will discuss the PCA3 test that may be helpful and prevent additional biopsies and additional psychological anxiety.

PCA3 Test

PCA3 is an acronym for Prostate CAncer gene 3. Prostate cells have PCA3 genes that are responsible for making this prostate cancer-specific protein. Prostate cancer cells produce higher levels of PCA3 than do healthy cells, and when the level of PCA3 protein is high, it leaks into the urine, where it can be measured. Unlike the PSA test, PCA3 is not affected by benign prostatic hyperplasia (enlarged prostate) or other noncancerous prostate conditions such as prostatitis.

To take the PCA3 test, you must first have a digital rectal examination (DRE), which stimulates the PCA3 to enter the urine. Then you must immediately provide a urine sample. Typically, it takes 1 to 2 weeks to obtain the results of the PCA3 test. For diagnostic purposes, the higher the PCA3 score, the more likely a man has prostate cancer. When the PCA3 score is used to help with treatment, the higher the score, the more aggressive the prostate cancer is likely to be.

The Food and Drug Administration approved the PCA3 test in 2012. Physicians can use the PCA3 score, in addition to DRE and PSA test, to help them make treatment decisions. For example, knowing a man’s PCA3 score can be helpful when:

  • Men have a family history of prostate cancer
  • Men have a positive biopsy, because their PCA3 score can provide additional information about how aggressive the cancer may be and therefore, be helpful in determining which treatment approach is best
  • Men have an elevated PSA or a suspicious DRE and are considering a prostate biopsy
  • Men have a negative result on their biopsy but the doctor is still uncertain about the presence of cancer
  • Men have a positive result on their biopsy and they and their doctor want to better understand how aggressive the cancer is
  • Men who have early, nonaggressive prostate cancer and have chosen active surveillance want to monitor any possible cancer progression

How effective is the PCA3 score in detecting prostate cancer? This question was addressed in a study involving 859 men who were scheduled to undergo a prostate biopsy. The authors found that use of the PCA3 test improved over-detection of low-grade prostate cancer and under-detection of high-grade cancer. Cost of the PCA3 test is about $450. The test is paid by most insurance companies including Medicare.

Bottom Line:  Prostate cancer is the most common cancer in men and the second most common cause of death in men.  The PSA test is a good screening test for men between the ages of 50 and 70.  However, there are false positive results with consequences of unnecessary prostate biopsies or may result in unnecessary repeat prostate biopsies.  The PCA3 test is helpful in identifying prostate cancer or helpful in reassuring a man that he doesn’t have prostate cancer and can avoid a repeat biopsy.  For more information, speak to your urologist.

Fido Finds Cancer-Dogs Used To Sniff Out Prostate Cancer

April 13, 2015

We have many high tech methods to detect cancer. We have blood tests, X-rays, CT scans, MRIs just to name a few. Now there’s a low tech means to detect prostate cancer using dogs. An Italian study showed a 93% reliability rate for detecting bladder and prostate cancer.

The latest research, by the Department of Urology at the Humanitas Clinical and Research Centre in Milan, involved two German shepherds sniffing the urine of 900 men – 360 with prostate cancer and 540 without.
Scientists found that dogs were accurate in 98.7% of cases.

They said the dogs are able to detect prostate cancer specific volatile organic compounds in the urine but said an important question remains of how a dog would find it in daily practice.

Prostate cancer is the most common cancer in men in the US, with more than 250,000 new cases diagnosed every year.

Dogs can pick up a scent in a dilution of one to a thousand parts. There is no single test for prostate cancer, but the most commonly used are blood tests, a physical examination or a biopsy.

The research has been published in the Journal Of Urology, one of America’s most prestigious urologic publications.

Bottom Line: Prostate cancer is one of the most common cancers in men and there are a myriad of tests to make the diagnosis. Perhaps in the near future we will be asking fido to help us out!