PROSTATE CANCER SCREENING

SCREENING (Rs 27, 000)

Tests: PSMA PET Scan| Digital Rectal Examination (DRE)| Prostate-Specific Antigen (PSA)| Full Blood Count (FBC)| Consultation

Prostate Specific Membrane Antigen (PSMA) PET SCAN

PSMA-PET scans are the most sensitive scans available for detection prostate tumours. This means that they are able to see small tumours where other types of scans miss them.

Australia is a world-leader in PSMA-PET scans. Unlike most other countries, PSMA-PET scans are commonly used by Australian men with recurrent prostate cancer. These scans can also be used by men who have been diagnosed with high-risk or metastatic prostate cancer.

The long name of this scan is gallium-68 PSMA PET-CT. There are two parts to the scan – an x-ray component (CT) and a PET scan.
CT scan: The CT scan uses x-rays taken in different directions to make a 3D image of the body.

PSMA-PET scan: PET scans use a radioactive dye to light up specific regions in the body. PSMA-PET scans look for areas of the body where the PSMA protein is found, showing the presence of prostate cancer cells. PSMA stands for prostate specific membrane antigen –  a protein found on the surface of prostate cancer cells. Gallium-68 refers to the radioactive part of the PET scan.

By combining the results from the CT and PET scans into one image, we can see the location of prostate tumours in the body.

When are PSMA-PET scans currently used?

These scans are used by some men with prostate cancer, despite being expensive.

They are useful for men:

⦁ who have been treated for localised prostate cancer but their PSA is rising (recurrent prostate cancer)
⦁ who have metastatic prostate cancer at the time of diagnosis
⦁ who are diagnosed with high-risk prostate cancer that appears localised (no tumours see in CT or bone scans).

Digital Rectal Examination (DRE)

A DRE is a test in which the doctor inserts a gloved, lubricated finger into the rectum to examine a person’s lower rectum, pelvis, and lower belly. This test can help your doctor check for cancer and other health problems, including:

⦁ Prostate cancer in men
⦁ An abnormal mass in the anus or rectum

A doctor may do a DRE as part of a routine medical examination. Or you may need a DRE if you have symptoms such as:

⦁ Rectal bleeding or blood in the stool
⦁ A change in bowel habits
⦁ A change in how your urine flows

Prostate-Specific Antigen (PSA) test

The PSA test is a blood test that measures the amount of prostate specific antigen (PSA) in your blood. PSA is a protein produced by normal cells in the prostate and also by prostate cancer cells. It’s normal to have a small amount of PSA in your blood, and the amount rises slightly as you get older and your prostate gets bigger. A raised PSA level may suggest you have a problem with your prostate, but not necessarily cancer.

What could affect the PSA level?

Prostate specific antigen (PSA) is produced by healthy cells in the prostate, so it’s normal to have a small amount of PSA in your blood. The amount rises as you get older because your prostate gets bigger.

Prostate problems, such as an enlarged prostate, prostatitis or prostate cancer, can cause your PSA level to rise – but lots of other things can affect your PSA level too, including the following.

⦁ A urine infection – You may have a test for a urine infection as this can raise your PSA level. If you have an infection, you’ll be given treatment for this. You’ll need to wait until the infection has gone – around six weeks – before you have a PSA test.
⦁ Vigorous exercise – You might be asked not to do any vigorous exercise in the 48 hours before a PSA test.
⦁ Ejaculation – You may be asked to avoid any sexual activity that leads to ejaculation in the 48 hours before a PSA test.
⦁ Anal sex and prostate stimulation – Receiving anal sex, or having your prostate stimulated during sex, might raise your PSA level for a while. It might be worth avoiding this for a week before a PSA test.
⦁ Prostate biopsy – If you’ve had a biopsy in the six weeks before a PSA test, this could raise your PSA level.
⦁ Medicines – Let your GP or practice nurse know if you’re taking any prescription or over-the-counter medicines, as some might affect your PSA level. For example, some medicines used to treat an enlarged prostate, known as 5-alpha-reductase inhibitors such as finasteride (Proscar®) or dutasteride (Avodart®), can reduce your PSA level and give a false test result.
⦁ Other tests or surgery – If you’ve had any tests or surgery on your bladder or prostate, you may need to wait up to six weeks before having a PSA test.
⦁ Urinary catheters – If you have a catheter to drain urine from your bladder, you may need to wait up to six weeks after it has been put in before having a PSA test.

Full Blood Count (FBC)

A full blood count (FBC) is a common blood test that your doctor may recommend to:
⦁ Help diagnose some blood cancers, such as leukemia and lymphoma
⦁ Find out if cancer has spread to the bone marrow
⦁ See how a person’s body is handling cancer treatment
⦁ Diagnose other, noncancerous conditions

A FBC measures the amount of 3 types of cells in your blood:

⦁ White blood cell count. A white blood cell count, also called a leukocyte count, measures the total number of white blood cells in a sample of blood. These cells protect the body from infection by attacking invading bacteria, viruses, and other foreign materials in the body. Some white blood cells can also attack cancer cells.

⦁ White blood cell differential. A white blood cell differential measures the number of each type of white blood cell. There are 5 major types of white blood cells, and each type plays a different role in protecting the body. Your doctor can learn valuable information about your health by measuring the levels of these cells:
⦁ Neutrophils
⦁ Lymphocytes
⦁ Monocytes
⦁ Eosinophils
⦁ Basophils

⦁ Red blood cell count. Red blood cells carry oxygen throughout your body. A red blood cell count, also called an erythrocyte count, measures the number of red blood cells in a sample of blood. There are several ways to measure red blood cells.

Two of the most common are:

⦁ Hematocrit (Hct), the percentage of your blood that is made up of red blood cells
⦁ Hemoglobin (Hgb), the amount of the protein in red blood cells that carries oxygen

⦁ Platelet count. A platelet count measures the number of platelets in a sample of blood. Platelets help to stop bleeding by forming blood clots.

The amounts of each of these types of cells have a normal range. Your health care team will note this range on your FBC lab results. A range is used instead of a specific number because a normal amount is different for each person.

By the time prostate cancer signs and symptoms develop, the cancer is usually too advanced for curative treatment. Studies show prostate cancer screening reduces the risk of dying of prostate cancer.