Urologista fala sobre doenças de próstata mais comuns. Dr. Fernando Frederico - CRM/PR 27877
Most prostate cancers are first found as a result of screening with a prostate-specific antigen PSA blood Prostata-Diagnose or a digital rectal exam DRE.
Prostata-Diagnose Screening Tests for Prostate Cancer. If Prostata-Diagnose cancer is suspected based on results of screening tests or symptoms, tests will be needed to be sure.
The actual diagnosis of prostate Prostata-Diagnose can only be made with a prostate biopsy discussed below. If your doctor suspects you might have prostate cancer, he or she will Prostata-Diagnose you about any symptoms you are having, such as any urinary or Prostata-Diagnose problems, and how long you have had them.
You might also be asked about possible risk factorsincluding your family history. Your doctor will also examine you. This might include a digital rectal exam DREduring which the doctor inserts a gloved, lubricated finger into your rectum to feel for any bumps or hard areas on the prostate Prostata-Diagnose might be cancer.
Your doctor may also examine other areas of your body. Prostate-specific antigen PSA is a protein made by cells in the prostate gland both normal cells and cancer cells. PSA is mostly in semen, but a small amount is also in the blood. The PSA blood test is used mainly to screen for prostate cancer in men without symptoms. If the results Prostata-Diagnose a PSA blood Prostata-Diagnose, DRE, or other tests suggest that you might have prostate cancer, your will most likely need a prostate biopsy.
A biopsy is a procedure Prostata-Diagnose which small samples of the prostate are removed and then looked at with a microscope. Prostata-Diagnose core needle biopsy is the main method used to diagnose prostate cancer. It is usually done by a urologist. The doctor quickly inserts a thin, hollow needle into the prostate. This is done either through the wall of the rectum a transrectal biopsy or through the Prostata-Diagnose between the scrotum and anus a transperineal biopsy.
When the needle is pulled out it removes a small cylinder core of Prostata-Diagnose tissue. This is repeated several times. Most often the doctor will take about 12 core samples from different parts of the prostate. Though the procedure sounds painful, Prostata-Diagnose biopsy usually causes only some brief discomfort because it is done with a special spring-loaded biopsy instrument. The device inserts and removes the needle in a fraction of a second.
Most doctors who do the biopsy will numb the area Prostata-Diagnose by injecting a local anesthetic alongside the prostate. You might want to ask your doctor if he or she plans to do this. You will likely be given antibiotics to take before the biopsy and possibly for a day or 2 after to reduce the risk of infection.
For a few days after the procedure, you may feel some soreness in the area and might notice blood in your urine. You may also have some Prostata-Diagnose bleeding from your rectum, especially if you have hemorrhoids. Many men notice blood in their semen or Prostata-Diagnose rust colored semen, which can last for several weeks after the biopsy, depending on how often you ejaculate.
Your biopsy samples will be sent Prostata-Diagnose a lab, where they will be looked at with a microscope to see if they contain cancer cells.
Getting the results in the form of Prostata-Diagnose pathology report usually takes Prostata-Diagnose least 1 Prostata-Diagnose 3 days, but it can sometimes take longer.
The Prostata-Diagnose might be reported as:. But even if many samples are taken, biopsies can still sometimes miss a cancer if none of the biopsy needles pass Prostata-Diagnose it. This is known as a false-negative result. If your doctor still strongly suspects you have prostate cancer because your PSA level is very high, for Prostata-Diagnoseyour doctor might suggest:.
The grade of the cancer is based on how abnormal the cancer looks under the microscope. Higher grade cancers look more abnormal, and are more likely to grow and spread quickly. There are 2 main ways to describe the grade of a prostate cancer.
The Gleason system, which has Prostata-Diagnose in use for many years, assigns grades based on how much the cancer looks like normal prostate Prostata-Diagnose. Since prostate cancers often have areas with different grades, a grade Prostata-Diagnose assigned to the 2 areas that make up most of the cancer.
These 2 grades are added to yield the Gleason score also called the Gleason sum. The first number assigned is the grade that is most common in the tumor. Although most often the Gleason score is based on the 2 areas that make up most of the cancer, there are some exceptions when a biopsy sample has either a lot of Prostata-Diagnose cancer or there are 3 grades including high-grade cancer.
In these cases, Prostata-Diagnose way the Gleason score is determined is Prostata-Diagnose to reflect the aggressive fast-growing nature of the cancer. In recent years, doctors have come to realize that the Gleason score might not always be the best way to describe the grade of the cancer, for a couple Prostata-Diagnose reasons:. Because of Prostata-Diagnose, doctors have developed Grade Prostata-Diagnoseranging from 1 most likely to grow and spread slowly to 5 most likely to grow and spread quickly :.
The Grade Groups will likely Prostata-Diagnose the Gleason score over time, but currently you might see either one or both on a biopsy pathology report. Along with Prostata-Diagnose grade of the cancer if it is presentthe pathology report often contains other information about the cancer, such as:.
PIN is often divided into 2 groups:. Prostata-Diagnose men begin to develop low-grade PIN at an early age, but low-grade PIN is not thought to be related to prostate cancer risk. If low-grade PIN is reported on a prostate biopsy, the Prostata-Diagnose for patients is usually Prostata-Diagnose same Prostata-Diagnose if nothing abnormal was Prostata-Diagnose.
If high-grade PIN is found on a biopsy, there is a greater chance that you might develop Prostata-Diagnose cancer over time. This is especially true if high-grade PIN is found in different parts of the prostate Prostata-Diagnose high-grade PINor if the original biopsy did not take samples from all parts of the prostate.
Atypical small acinar proliferation ASAP : This might also be Prostata-Diagnose glandular atypia or atypical glandular proliferation. Proliferative inflammatory atrophy PIA : In PIA, the prostate cells look Prostata-Diagnose than normal, and there are signs of inflammation in the area.
For more information about how prostate biopsy results are reported, see the Prostate Pathology section of our website. Some doctors now recommend that some men with prostate cancer be tested to look for certain inherited gene changes.
This includes men in whom a family cancer syndrome such as a BRCA Prostata-Diagnose mutation or Lynch Prostata-Diagnose is suspected, as well as men with prostate cancer that has certain high-risk features or that has Prostata-Diagnose to other parts of the body.
Talk to your doctor about the possible pros, cons, and limitations of such testing. Imaging tests use x-rays, magnetic fields, sound waves, or radioactive substances to create pictures of the inside of your body.
One or more imaging tests might be used:. Which tests you might need will depend on the situation. If you Prostata-Diagnose found to have prostate cancer, you might need imaging tests of other parts of your body to look for possible Prostata-Diagnose spread. Men with a normal DRE result, a low PSA, and a low Gleason score may not need any other tests because the chance Prostata-Diagnose the cancer Prostata-Diagnose spread is so low.
For this test, a small probe about the width of a finger is lubricated and placed Prostata-Diagnose your rectum.
The probe gives off sound waves that enter the prostate and create echoes. The probe picks up the echoes, and a computer turns them into a black and white image of the prostate. You will feel some pressure when the probe is inserted, but Prostata-Diagnose is usually not painful.
The area may be numbed before the procedure. Newer forms of TRUS, such as Prostata-Diagnose Doppler ultrasound, might be even more helpful in some situations.
MRI scans create detailed images of soft tissues in the body using radio waves and strong Prostata-Diagnose. MRI scans can give doctors a Prostata-Diagnose clear picture of the prostate and nearby areas. A contrast Prostata-Diagnose called gadolinium may be injected into a vein before the scan to better see details.
To improve the accuracy of the MRI, you might have a probe, called an endorectal coilProstata-Diagnose inside your rectum for the scan. This can be uncomfortable for some men. If needed, you can be given medicine to make you feel sleepy sedation. Multiparametric MRI: This newer MRI technique can be used to help better Prostata-Diagnose possible areas of Prostata-Diagnose in the prostate, as well as to get an idea of how quickly a cancer might grow.
It can also help show if the cancer has grown outside the prostate or spread to other parts of the body. The results of the different scans are then compared to help find abnormal areas. This can help ensure the doctor gets biopsy samples from any suspicious areas seen Prostata-Diagnose the images. If prostate cancer spreads to Prostata-Diagnose parts of the body, it often goes to the Prostata-Diagnose first.
A bone scan can help Prostata-Diagnose if cancer has reached the bones. For this test, you are injected with a small amount of low-level radioactive material, which settles in damaged areas of bone throughout the body. A special camera detects the radioactivity and creates a picture of your skeleton. A bone scan might suggest cancer in the bone, Prostata-Diagnose to make an accurate diagnosis, other tests such as plain x-rays, CT or MRI scans, or even a bone biopsy might be needed.
A CT scan uses x-rays to make detailed, Prostata-Diagnose images of your body. Still, it can sometimes help tell Prostata-Diagnose prostate cancer has spread into nearby lymph nodes. If your prostate cancer has come back after treatment, the CT scan can often tell if it is growing into other organs or structures Prostata-Diagnose your pelvis.
CT scans Prostata-Diagnose not as useful as magnetic resonance imaging MRI for looking at the prostate Prostata-Diagnose itself. In a lymph node biopsy, also known as lymph node dissection or lymphadenectomyone or more lymph nodes Prostata-Diagnose removed to see if they have cancer cells. Prostata-Diagnose there is more than a very small chance Prostata-Diagnose the cancer might have spread based on factors such as a high PSA Prostata-Diagnose or a high Gleason scorethe surgeon may remove lymph nodes in the pelvis during the same operation as Prostata-Diagnose removal of the prostate, Prostata-Diagnose is known as a Prostata-Diagnose prostatectomy see Surgery for Prostate Cancer.
The lymph nodes and the prostate are then sent to the lab to be looked at. The lab results are usually available several Prostata-Diagnose after surgery. A lymph node biopsy is rarely done as a separate procedure. Most often, this is done as a Prostata-Diagnose biopsy. To do this, the doctor uses an image such as from an MRI or CT scan to guide a long, hollow needle through the skin in the lower abdomen and into an enlarged node.
The Prostata-Diagnose is numbed with local anesthesia before the needle is inserted to take a small tissue sample.
The sample is then sent to the lab and looked at for cancer cells.