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Prostate Cancer

Read the story of ASCP Patient Champion Travis and learn about the role
of laboratory testing in the diagnosis and treatment of prostate cancer.

What is Prostate cancer?

Prostate cancer is cancer that originates in the prostate. The prostate is a small gland that produces fluids and hormones related to male reproduction and is only present in men. Prostate cancer is most common in people over 60 years of age.

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69��al Materials: Prostate Cancer

Cells from the prostate gland in a typical case of prostate cancer.

Travis’ Story

Travis first noticed something was different through the lab tests conducted as part of his annual physical. His PSA, which stands for prostate specific antigen and is measured in peripheral blood, were higher than normal. PSA tests can be used to indicate higher levels of protein in the prostate, however they do not indicate a specific diagnosis. When his levels continued to rise at his next annual physical exam, his doctor suggested a biopsy to try to find the cause of these elevated levels. Travis’ biopsy did not reveal anything, but since his PSA levels continued to rise, his urologist recommended an MRI-guided biopsy. First an MRI image is created of the prostate that then indicates the location of a mass (if there is one). Then, a targeted biopsy is performed directly into the mass. This biopsy confirmed Travis had prostate cancer. “Receiving the diagnosis of prostate cancer was quite frightening,” says Travis. In his case, the cancer was located in an area that was difficult to feel by a physician on a rectal examination which is why it was only detected with an MRI. Thanks to continued lab tests, the cancer was found and treated.

The second biopsy showed that Travis’ cancer was incredibly aggressive, so he decided to have a prostatectomy, which removed the prostate gland. The surgery completely removed the tumor, and he also has no long-term side effects. He is closely monitored through follow up treatments, but the expectation is that the cancer will not reoccur. “Because the diagnosis was early enough to do something about it, my future is actually quite good,” says Travis. “I am back at work enjoying my friends and family and look forward to resuming my travel schedule in the months to come.”

Travis and his medical team collaborated to find and treat his prostate cancer.

Lee’ Story

“Without the lab, I may have succumbed to metastatic disease in the future.”

As a pathologist, former ASCP President, and lifelong advocate for patient-centered care, Lee has spent his entire career aware of the importance of lab testing and spent years acting as a resource to his friends, family and patients navigating cancer diagnoses. When he started to see the signs of prostate cancer at 66, he wasn’t shocked and saw it as his turn to undergo treatment.

Lee started getting routine PSA blood test screenings in his forties given his father had prostate cancer. PSA, or Prostate Specific Antigen, is a protein created by prostatic tissue. PSA tests can indicate higher levels of this protein in the blood; however, they do not indicate a specific diagnosis, such as cancer. In fact, 15 years earlier he had an elevated PSA but biopsy did not show the presence of cancer. When his PSA results started to increase, again, faster than expected, Lee’s doctor sent him to get an MRI, where they saw a mass in his prostate that was suspicious for cancer. After talking to his urologist, Lee decided on surgical treatment to remove his prostate.

Lee is very familiar with the diagnosis and treatment of prostate cancer, but that didn’t remove the emotional aspect of his diagnosis: “It’s scary even if you know what it is and know what to do. You ask yourself ‘Why Me’?”

To combat his anxiety about treatment, Lee reached out to other prostate cancer survivors, including other Patient Champions, for support and community. Connecting with his support system was vital to his recovery. He also focused on the logistics of the treatment, rather than his fears: “I focused on what I needed to do to deal with, rather than the anxiety of it. It was in the background, but I had to do what I had to do.”

He has the following advice for other patients “If you are worried about the diagnosis, the best thing you can do is take care of it. Make sure you have a good clinical team, including an internist and urologist that can help you make the right decision about treatment. In the long term, you are far better off dealing with something, as scary as it is, rather than avoiding it.”

Questions To Ask Your Doctor

How often should I monitor my PSA?
My biopsy was negative – but my PSA is still rising? Should I be concerned?
Are there different techniques to perform a biopsy (e.g., random sample, MRI guidance)?

I have a positive biopsy, what does the Gleason score mean?
What are my treatment options if my biopsy is positive?
If I’ve been treated, who will follow up to make sure I am doing okay?

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