Prostate cancer

Prostate cancer is a group of cancerous cells (a malignant tumor) that begins most often in the outer part of the prostate. It is the second most common type of cancer in men in the United States. Skin cancer is the most common. Of all the men who are diagnosed with cancer each year, more than one-fourth have prostate cancer.

Biopsy

If test results suggest that cancer may be present, the man will need to have a biopsy. During a biopsy, the doctor removes tissue samples from the prostate, usually with a needle. A pathologist looks at the tissue under a microscope to check for cancer cells. If cancer is present, the pathologist usually reports the grade of the tumor. The grade tells how much the tumor tissue differs from normal prostate tissue and suggests how fast the tumor is likely to grow. The most common method of grading prostate cancer, called the Gleason system, uses scores of 2 to 10, with 10 indicating the most aberrant growing and 'cancerous' samples. The pathologist assigns a number between 1 and 5 to the most common pattern observed under the microscope. The second most common pattern is also assigned a number. The sum of these numbers makes up the Gleason score. Another system uses G1 through G4. It is important that the pathologist grading the tumor have a lot of experience looking at prostate tumors, as the grade of the tumor is one of the major factors in determining the treatment recommendation. This is because tumors with higher scores or grades are more likely to grow and spread than tumors with lower scores.

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If the physical exam and test results do not suggest cancer, the doctor may recommend medicine to reduce the symptoms caused by an enlarged prostate. Surgery is another way to relieve these symptoms. The surgery most often used in such cases is called transurethral resection of the prostate (TURP or TUR). In TURP, an instrument is inserted through the urethra to remove prostate tissue that is pressing against the upper part of the urethra and restricting the flow of urine. This procedure was more common in the past. (Patients may want to ask whether other procedures might be appropriate.)

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