Prostate cancer: diagnosis and staging

Asian J Androl. 2009 Jan;11(1):74-80. doi: 10.1038/aja.2008.19. Epub 2008 Dec 1.

Abstract

Prostate cancer represents an increasing health burden. The past 20 years, with the introduction of prostate-specific antigen (PSA), has seen prostate cancer move increasingly from a condition that presented with locally advanced disease or metastases to one that is found upon screening. More is also known about the pathology of pre-malignant lesions. Diagnosis relies on trans-rectal ultrasound (TRUS) to obtain biopsies from throughout the prostate, but TRUS is not useful for staging. Imaging for staging, such as magnetic resonance imaging or computed tomography, still has a low accuracy compared with pathological specimens. Current techniques are also inaccurate in identifying lymph node and bony metastases. Nomograms have been developed from the PSA, Gleason score and clinical grading to help quantify the risk of extra-capsular extension in radical prostatectomy specimens. Improved clinical staging modalities are required for more reliable prediction of pathological stage and for monitoring of response to treatments.

Publication types

  • Review

MeSH terms

  • Biomarkers, Tumor / blood
  • Biopsy
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Neoplasm Staging / methods*
  • Prostate-Specific Antigen / blood
  • Prostatic Neoplasms / blood
  • Prostatic Neoplasms / diagnosis*
  • Prostatic Neoplasms / pathology*
  • Tomography, X-Ray Computed

Substances

  • Biomarkers, Tumor
  • Prostate-Specific Antigen