This past winter, I went back to my hometown in France. I managed to have a one-on-one with my closest friends while masked and distanced to protect us both from COVID-19.
This year, the central theme of our discussions was prostate cancer. My friends’ dad was diagnosed with prostate cancer two years ago at 65 years old. The tumor was discovered at an early stage thanks to the active surveillance he started 10 years earlier.
Prostate cancer is something that all men worry about. However, knowledge is power, so let us teach you the four prostate cancer stages and how to detect prostate cancer early.
In this post, you will learn how to recognize the signs and common symptoms of each stage of prostate cancer and how a screening routine can help you detect prostate cancer at a treatable stage.
The prostate gland is an organ involved in male reproduction. Its primary role is to secrete seminal fluid to give sperm an optimal environment to survive in and travel through during ejaculation. The prostate is located just in front of the bladder, around the urinary tract.
Prostate cancer is dysregulation of the prostate tissue’s division. Cancer cells proliferate indefinitely, and as the tumor grows, it puts pressure on the nearby tissues and organs. This disturbs their normal function.
Following the tumor’s development, its progression is divided into four prostate cancer stages, from stage I (early stage) to stage IV (advanced prostate cancer). Doctors use specific metrics to categorize them.
There are two prostate cancer staging systems:
Gleason score is a grading system used to determine how aggressive your prostate cancer is and to classify the prostate cancer stages. Each patient biopsy sample receives two scores: one for the cells observed in the largest tumor area and one assigned to the second-largest tumor area.
The Gleason score is essential when evaluating prostate cancer behavior, but other factors like prostate-specific antigen (PSA) levels play a role in the diagnosis.
TNM stands for tumor, node, and metastasis, which the system evaluates.
The American Joint Committee on Cancer (AJCC) and the International Union Against Cancer adopted the TNM system to help oncologists identify cancer stages and provide an appropriate treatment plan.
The TNM system takes the Gleason score and the blood’s PSA level into consideration. Here’s how the scores break down:
The symptoms of prostate cancer depend on the cancer’s stage.
For early stages (stages I and II), signs or symptoms are usually not perceptible. However, during advanced stages (stages III and IV), you may experience:
In any case, don’t wait for symptoms to appear. When detected at an early stage, the chances of surviving prostate cancer are nearly 100%.
Age is the leading risk factor for developing prostate cancer. That means the earlier you start screening, the better chance you have of detecting it early.
Men who are age 50 and older and average risk should consider having prostate cancer screenings, according to the American Cancer Society. However, screening decisions should begin sooner for high-risk men who are at least 40-years-old.
Before planning your prostate screenings, it’s important to assess your risk level. Here are the factors to consider:
If you are a man over the age of 50 or at risk of developing prostate cancer, your primary care practitioner may prescribe one or more of these screening tests:
Blood work will measure your PSA level. A concentration of 0.6 to 0.7 ng/ml is considered normal in 40 to 50-year-old men. However, an increase above 0.7 ng/ml will raise concerns about cancer.
While the PSA test is the most common test used to detect prostate cancer, studies showed it is not the most accurate. An estimated 70% to 80% of men with high PSA concentration don’t have cancer.
The DRE is a test performed at your doctor’s office. Your PCP will palp your prostate gland by inserting a gloved and lubricated finger into your rectum. If palpable, your prostate cancer could already be at stage II. TNM scoring of the biopsy will rule out any suspicion of cancer.
Besides PSA level and DRE exams, your doctor may direct you to non-invasive imaging tests exams:
To make an informed decision about undergoing a routine screening of your prostate, talk to your doctor. You can also take the ezra Know Your Risk questionnaire to help give more information regarding your cancer risks.
An MRI of the prostate plus DRE or PSA tests can help provide a more detailed picture of your prostate’s health.