PSA, MRI and Gleason Score Testing

PSA, MRI, Gleason Score and Prostate Cancer

Advances in modern medicine make it easier to detect Prostate Cancer

How is Prostate Cancer Detected?

Today, most prostate cancer is detected by blood testing. Prostate Specific Antigen (PSA) is a blood test used to screen for prostate cancer. In general, a jump in PSA or a high PSA (over 2.5 ng/ml or 4.0 ng/ml) can be concerning. PSA is not perfect. Other conditions such as enlarged prostate or prostate infection could also have an elevated PSA.

MRI's
Today, MRIs are increasingly being done to improve the diagnosis of prostate cancer. Currently, the state of the art is to get a multiparametric 3 tesla MRI of the prostate (3T mpMRI). The report should come from a radiologist experienced in reading 3T mpMRI images. The MRI can reveal where a likely cancer resides in the prostate and if it is extending outside of the prostate. The radiologist uses a PI-RADS score (scoring 1-5) to indicate the likelihood of prostate cancer. 
Insurances usually cover an MRI if a prior biopsy showed no cancer but the PSA continues to rise. Some patients who are nervous about a biopsy can pay out of pocket to see if the MRI shows areas concerning for prostate cancer. We have negotiated reasonable cash pay rates with an experienced MRI center in town. 

If an MRI shows higher risk PI-RADS lesions, we can perform a fusion biopsy to do a “smart biopsy” instead of a conventional prostate biopsy.

Digital Rectal Exams

Digital rectal exams (DRE) can sometimes help detect prostate cancer. Many urologists continue to use DRE, as it can pick up a significant percentage of prostate cancer, but it is being used less as other tools continue to be developed to help pick up prostate cancer.

The diagnosis of prostate cancer can only be done with a biopsy. The biopsy procedure is usually done in a urology office or in a surgery center. The tissue is sent to a lab and analyzed by a pathologist. 



Share by: