November 14th, 2007 
Von 
Prostate cancer diagnosis begins with a digital rectal examination by the health care professional. Additional tests such as a transrectal or transperineal needle biopsy can detect small prostatic nodules or more advanced cancerous growth. Transrectal ultrasound is also used for both diagnosis and to help guide needle biopsy. Serum acid phosphatase levels can be elevated when there is local extension or metastasis of disease.
However, other conditions such as benign prostatic hyperplasia, multiple myeloma, Gaucher’s disease, and hemolytic anemia can also raise these levels. Radioimmunoassay analysis of prostate-specifi c antigen (PSA) has become a standard test for diagnosing both localized as well as metastasized stages of the prostate cancer. Though controversial, PSA is the most sensitive marker for monitoring disease and is elevated in 25 to 92% of patients with prostate cancer. However, it is also raised in 30 to 50% of those with BPH. Prostate cancer often leads to osteoblastic (bone-formation cells) bony metastases, which are often detected on bone scans or x-rays of prostate cancer patients. Physicians often have diffi culty in identifying what types of prostate cancers will spread and become dangerous. A new protein called KAI-1 has been identifi ed as a marker for disease. If signifi cant levels of KAI- 1 are found in cancerous tissues, the cancer is not likely to spread. If the protein is not found, cancer typically spreads.
Prostate cancer has been classifi ed into four stages:
• Stage A. The tumor is not found by normal tests but during surgery for a different prostate condition.
• Stage B. The tumor can be palpated during rectal examination but it has not spread beyond the prostate
• Stage C. Cancer has spread to tissues outside of the prostate.
• Stage D. The cancer has metastasized to the lymph nodes of the pelvis or to other parts of the body, especially the bones.
Source:Prostate Cancer Fund,(a special program of Project Cure Foundation)
P.O. Box 96673, Washington, D.C. 20090-6673 • 1-800-716-2152. Photo courtesy of www.meb.uni-bonn.de
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