Question 1

I’ve been diagnosed, now what?"

Accepted Answer

Don’t think of your cancer diagnosis as a death sentence. It is a wake-up call! Get a second opinion. Be proactive in researching your options. Stay in the driver’s seat and take the time you need to make the decisions that are right for you.

Question 2

Where is my prostate and what is its function?

Accepted Answer

A wonderfully succinct explanation of this walnut-sized gland, which is part of the male reproductive system, is offered by WebMD: “It rests below your bladder and in front of your rectum. It surrounds parts of the urethra, the tube in your penis that carries pee from your bladder. The prostate helps make some of the fluid in semen which carries sperm from your testicles when you ejaculate.”   Semen includes PSA (prostate specific antigen), which you may be familiar with since the PSA measurement is one of the readings given following a blood screening. The prostate also uses male hormones (referred to as androgens) to trigger the adolescent development of male gender characteristics and their maintenance throughout life.   Nerves run along the sides of the prostate and impact erectile function which can be damaged during surgery.   It is interesting to note that the area of the prostate which surrounds the urethra, continues to grow throughout your lifetime (as do your nose and ears!). Most men experience the discomfort and inconvenience of an ‘enlarged prostate’ as they age. As explained on Cedar-Sinai.edu, “the layer of tissue around the prostate keeps it from growing outward. As a result, the prostate gland begins to press on the urethra like a clamp.” This benign condition impacts one's ability to fully empty the bladder at one sitting, and can be the cause of multiple and urgent trips to the bathroom.

Question 3

Why do Drs. conduct a digital rectal test for cancer?

Accepted Answer

Because of the location of the prostate gland in front of your rectum, inserting a lubricated, gloved finger into the rectum is effective in giving a doctor the feel of the gland and the presence of lumps or irregularities.   Prostate cancer screenings begin with a blood test, followed by a digital rectal exam. It is ALWAYS to be done in this order since any stimulation of the prostate can temporarily raise the PSA readings. Benign factors which can raise PSA readings include: age, constipation, recent sexual activity, bike riding, infection and an enlarged prostate.

Question 4

Why was a biopsy and ultrasound recommended and how is it done?

Accepted Answer

Au ultrasound-guided biopsy of the prostate can be recommended if your screenings show evidence of irregularities and suspicion of the presence of cancer. During a biopsy, a sample of the prostate will be taken by inserting a needle up through your rectum and into the prostate gland.

Question 5

My Dr. ordered an MRI of my prostate? Why?

Accepted Answer

Although Magnetic Resonance Imaging (MRI) has been found to be most accurate in detecting tumors, the widespread use of MRI is not presently routinely used due to barriers of cost, lack of expertise and other limitations. However, The New England Journal of Medicine in March 2018 reported that the recent PRECISION study of 500 men, “…demonstrated a 12% absolute improvement of the rate of cancer detection for those with MRI prior to biopsy and MRI targeted biopsy, compared with men who just had ultrasound-guided biopsy.”, according to Dr. Hu. It was also reported that “28% of the men in the study’s MRI group were able to avoid biopsy when their imaging showed no evidence of cancer.”

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