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Tests That Help Evaluate Prostate Cancer

Your doctor took a biopsy from your prostate to know that you have cancer.

Your doctor may request more tests to learn more about your cancer and its specific location to help decide on the treatment that is likely to be most effective for you. You may also need to have imaging tests, which help your doctor see what's happening in your body. Here are some of the imaging tests you may need to have.

Bone scan

This test shows whether cancer has spread to your bones. Your doctor may recommend a bone scan to help find out the stage of your cancer if your PSA level was high, if your Gleason score indicated that the cancer might be aggressive, if the cancer has spread outside the prostate, or if you are having bone pain.

A bone scan is a kind of radionuclide scanning. For this test, you're injected with a small amount of radioactive substance. It travels through the bloodstream and collects in areas of abnormal bone growth. You'll lie on a table for about 30 minutes while a machine scans your body for the places the substance has collected. The amount of radioactive material used for this test is small. It shouldn't be harmful to you or your family. If your doctor sees suspicious places, you may also have other tests, such as bone X-rays, an MRI, or a CT scan.

Magnetic resonance imaging (MRI)

MRIs may be used to determine if cancer has spread outside your prostate gland. For instance, it can spread into your lymph nodes. Or it can spread to other areas around the prostate, such as the seminal vesicles or bladder. MRIs produce a very clear picture of your prostate. Your doctor may recommend an MRI if your PSA or other tests indicate that the cancer may have spread outside the prostate.

In some cases, the technician will place a probe into your rectum to get better pictures. For this test, you lie still on a table as it passes through a tubelike scanner. Then the scanner rotates around you. As it moves, it directs a continuous beam of magnetic waves at the area being examined. A computer uses the data from the magnetic waves to create a detailed picture of the inside of your body. You may need more than one set of images. Each one may take two to 15 minutes, so the whole scan may take an hour or more. This test is painless and noninvasive. You may want to ask for earplugs if they aren't offered, since the machine produces a loud thumping noise during the scan. If you're claustrophobic, you may be given a sedative before having this test.

Computed tomography scan (CT scan)

During a CT scan, X-rays scan the pelvis in about 15 to 25 seconds. These special X-rays are much more sensitive than a typical X-ray. When you have prostate cancer, these pictures can help your doctor see if the tumors have spread into lymph nodes in your pelvis or into other organs. Unfortunately, like MRIs, CT scans have not been helpful in finding smaller amounts of cancer in the pelvic lymph nodes. Your doctor may recommend a CT scan if your PSA or other tests indicate that the cancer may have spread outside the prostate.

To have the test, you lie still on a table as it gradually slides through the center of the CT scanner. Then the scanner rotates around you, directing beams of X-rays at your pelvis. A computer uses the data from the X-rays to create many pictures of your pelvis, which can be used together to create a detailed picture. A CT scan is painless and noninvasive. You may be asked to hold your breath one or more times during the scan. In some cases, you may be asked to drink a contrast dye four to six hours before the scan. And you may be asked not to eat anything in the time between drinking the contrast dye and the scan. The contrast dye will gradually pass through your system and exit through your bowel movements.


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