Malignant Tissue Change
Prostate cancer arises when normal cells in the prostate gland mutate into cancer cells that then propagate and form malignant tumors. While advanced-stage prostate tumors may exhibit significant growth and spread to other areas of the body, early-stage prostate cancer is not generally characterized by tissue enlargement. This makes it difficult to detect prostate cancer at an early stage. However, given that prostate cancer tends to trigger an increase in the concentration of a protein known as prostate specific antigen (PSA) in the blood, an elevated PSA level may be an early signal that something is amiss.
Diagnosing Prostate Cancer
Doctors typically refer to prostate tumors as cancerous when a biopsy is performed and a pathologist assesses the removed sample of tissue as having a Gleason score of anywhere from 6 (3+3) to 10 (5+5). The specific degree of malignancy will be an important factor when it comes to determining an appropriate form of treatment. While tumors at the lower end of the Gleason scale (e.g. a score of 6) are indeed malignant, they tend not to be aggressive and are usually not life threatening. Tumors assigned a Gleason score of 7 may exhibit the same characteristics of a tumor with a Gleason score of 6, or they may show more aggressive development and move up the scale to a Gleason score of 8 such as in the case of a Gleason score of 7 (4+3). Tumors assigned Gleason scores of 8, 9 or 10 are highly aggressive.
Prostate Cancer Risk Factors
Other than skin cancer, prostate cancer is the most common type of cancer in men. Its incidence among men is similar to that of breast cancer among women. While prostate cancer may occur in men of all ages, it is a disease that tends to affect men as they age, with its incidence increasing significantly from the age of 50. There are a number of factors that are associated with a higher risk of prostate cancer.
These risk factors include:
- PSA levels of greater than 2 ng/ml
- Rising or fluctuating PSA levels
- Family history of prostate cancer (e.g. father or brother)
- Urinary dysfunction
Arriving at a Prognosis
Statistics indicate that more than 60% of all detected prostate tumors are slow-growing and not life threatening. These tumors range from 6 to 7a (3+4) on the Gleason grading scale. This lower degree of malignancy is one reason why ever more men with prostate cancer opt for treatment involving organ-sparing surgery or active surveillance as opposed to immediate treatment.
Even in the case of aggressive prostate tumors, the prospects for effective treatment tend to be favorable so long as they are diagnosed at an early stage. Treatment in such cases usually involves total prostatectomy, radiation therapy, chemotherapy, or androgen-deprivation therapy.
Prostate MRI for an Early and Reliable Diagnosis
Multiparametric MRI of the prostate qualifies as the most reliable imaging procedure for diagnosing prostate cancer. MRI enables your doctor to detect cancerous lesions and to evaluate their properties.
Once detected, the degree of a given tumor’s malignancy needs to be determined by a pathologist. In order to enable such an examination, a so-called biopsy is carried out to remove a sample of tissue from the “area of interest” in the prostate. At the ALTA Klinik, we use MRI as a guide when carrying out our prostate biopsies. This enables us to remove tissue samples precisely from the suspicious areas of the prostate that have been detected so that the pathologist can assess the relevant tissue according to the Gleason grading system.
Prostate MRI as a Basis for Effective Treatment
Multiparametric MRI of the prostate can provide the following critical information to support the treatment process:
- Detection of a malignant tumor
- Position of a tumor
- Size and volume of a tumor
- Spatial extent of a tumor
- Possible spread of disease to neighboring structures or organs
- Possible invasion of lymph nodes in the pelvic region
- Possible detection of metastases in the bones of the pelvis
For more on this subject, please refer to Prostate MRI