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12

NCCN Guidelines for Patients

®

Prostate Cancer, Version 1.2016

2

Cancer staging

12 Prostate-specific antigen

13 Digital rectal exam

14 Prostate MRI

15 Prostate biopsy

16 Gleason score

18 TNM scores

20 Review

A cancer stage is a rating by your

doctors of how far the cancer has

grown and spread. There are 4 stages

of prostate cancer. Staging is based

on test results. Doctors plan additional

tests and treatment based on how

much the cancer has grown. In Part 2,

the tests and scoring system used for

staging prostate cancer are explained.

Prostate-specific antigen

PSA (

p

rostate-

s

pecific

a

ntigen) is a protein made by

the fluid-making cells that line the small glands inside

the prostate. These cells are where most prostate

cancers start. PSA turns semen that has clotted after

ejaculation back into a liquid.

PSA can be measured from a blood sample since

some of it enters the bloodstream. PSA values are

used for cancer staging, treatment planning, and

checking treatment results. PSA values discussed in

this book include:

• PSA level

is the number of nanograms of

PSA per milliliter (ng/mL) of blood.

• PSA density

is the PSA level in comparison

to the size of the prostate. It is calculated

by dividing the PSA level by the size of the

prostate. The size of the prostate is measured

with a TRUS (

t

rans

r

ectal

u

ltra

s

ound).

• PSA velocity

is how much PSA levels change

within a period of time.

• PSA doubling time

is the time it takes for the

PSA level to double.