Hey guys, if you or a loved one has recently received a prostate cancer diagnosis then this video is here to provide you with some background information so that you maybe better prepared for your upcoming journey through treatment choices, cancer and functional outcomes.
The journey starts for most men with a call from your urologist saying that the biopsy was positive and that prostate cancer was found. At this time your urologist may give you information regarding the Gleason Score or Gleason Grading group. Armed with this information you will now have an idea about you risk group. This risk group is assigned on the basis of your PSA (blood test) at diagnosis, how your prostate feels during the examination (clinical stage), and the Gleason score.
The PSA is usually performed by your GP. For most it is elevation of this blood test which results in a referral through to an urologist for further evaluation. Here is a chart highlighting normal PSA values for various age brackets.
After the PSA test most men will have a prostate examination. Following on from an elevated PSA and/or an abnormal prostate examination men will be referred through to have an MRI scan. This is a more specific test which gives us a picture inside the prostate and more accurately provides a risk that a man has prostate cancer. This test usually takes around 30 minutes to perform. Below is an example of what an MRI prostate looks like. At The Prostate Clinic all men are reviewed after this scan so that we can make a decision on what the step should be. If there is a lesion identified on the scan nest men will have an Artemis fusion targeted biopsy of it. Thankfully the days of the transrectal biopsy (tissue sample taken through the bowel wall) are well and truly over.
After the biopsy, the key information regarding what type of tumour someone has will be clear. Biopsy itself is there to confirm (or exclude) the presence of prostate cancer and also to provide information regarding the Gleason Grade and Gleason grading group.
The next step in the process is to confirm that there is no spread of the tumour which can be done using a PSMA PET scan. This is a specialised whole body scan which provides accurate information regarding evidence of any spread of disease.
Armed with this information hopefully men will better understanding the decision making process and why we as urologists make the recommendations that we do. Good luck with your research! For more information on this topic have a look at our YouTube video highlighting the same content.