The prostate specific antigen or PSA test is a test used to help detect prostate cancer. This test is done by taking a blood sample and sending it to the laboratory. It is commonly used, together with a prostate examination, as one of the first tests in suspected prostate cancer. An elevated PSA does not necessarily mean prostate cancer is present, as PSA levels can be raised for a number of reasons, but it can help determine whether further tests are required.
The PCA 3 test is a test performed on urine samples taken after a urologist has done a massage of the prostate gland during a rectal examination. It is sometimes used when prostate cancer is suspected but a biopsy of the prostate has not shown cancer. The PCA 3 test has been suggested to be a better test than PSA, for the purpose of detecting prostate cancer, but research is still being done to determine whether this is true. It is not an alternative to getting a tissue sample of the prostate (link to prostate biopsy) which is currently the most reliable way to diagnose prostate cancer. The Cambridge Urology Clinic consultants believe that the PCA3 test has a specific role in helping to diagnose prostate cancer in some men, and we are happy to offer this test to patients. More importantly however, we offer full discussion about the benefits, limitations and use of this test.
A prostate biopsy may be necessary if there is a suspicion of prostate cancer. In this procedure an ultrasound probe is passed into the rectum to visualise the prostate. After giving a local anaesthetic, 10-12 tissue biopsies are taken from the prostate using a fine needle. The procedure takes about 20 minutes. The tissue biopsies are then sent to the laboratory to be checked. A common side effect is blood in the urine and rectum but this is usually short lived. There is also a small risk of infection and all men are given antibiotics before and after the procedure.
This is an operation to remove the entire prostate. It is primarily recommended for men with disease confined to the prostate. In this operation the prostate and seminal vesicles are removed and the bladder is joined to the urethra. The operation has a high success rate in curing prostate cancer if the disease is caught early enough. This operation can be done by open surgery, laparoscopic surgery or robotic surgery. Consultants at The Cambridge Urology Clinic work in the department of urology at Addenbrooke’s hospital, where the operation is done using the Da Vinci Robotic system. The operation involves an in hospital stay of about 1-3 days and a catheter is left in place for about 7-10 days afterwards. The main long term complications of this operation are incontinence (whereby men may leak urine) and difficulty getting erections.