Metastatic prostate cancer
Diagnosis and tests
What tests will I have?
If you are diagnosed with metastatic prostate cancer, you may have tests to find out how far the cancer has spread. If you are generally not very well it may not be necessary to do extra tests. Your doctor will still be able to recommend treatment.
You may have some or all of the following tests:
Prostate specific antigen (PSA) is a protein that can rise due to disease in your prostate gland. A sample is taken from your blood and measured. A PSA test can also show how well your cancer is responding to treatment.
A biopsy is where a sample of your prostate tissue is taken and examined under a microscope. It isn’t common to have a biopsy with metastatic prostate cancer, but if this is your first prostate cancer diagnosis it may be necessary. Treatment can still start without a biopsy.
Metastatic prostate cancer often spreads to the bones. Bone scans can find cancer spots before they show up on an ordinary X-ray. For this test, a tiny amount of radioactive liquid is put into a vein, usually in your arm. After the injection you will have to wait up to 3 hours. A scan is then taken of all the bones in your body. Abnormal bone takes up more radioactive liquid than normal bone. These areas will show up on the scan and are known as 'hot spots'. The scan can also show bone changes like arthritis.
It's nice to have someone with you to keep you company if you're having this test, as it takes a while and involves a bit of waiting around.
You may have bone X-rays if the bone scan shows up ‘hot spots’. These X-rays will help to confirm if the cancer has spread or not. A chest X-ray may be done to check your general health
This is a special type of X-ray that builds up a detailed picture of the tissues around your chest, abdomen and pelvis. The scan is painless and takes 10-30 minutes.
Read more about a CT scans.
A scan that uses magnetic energy to build up a picture of the tissues in your chest, abdomen and pelvis. During the scan you will lie inside a tunnel-like machine.
Read more about MRI scans.
A PET scan uses a low dose of radioactive sugar to measure the activity in your cells. It is also used to diagnose or determine the stage of a number of different cancers.
Read more about PET scans.
This scan uses a special antibody molecule and radioactivity to look for areas of the body where the PSMA protein is found, showing the presence of prostate cancer cells. It is often used when there is biochemical recurrence.
Read more about cancer tests.
If you are diagnosed with metastatic prostate cancer, we're here for you.
Our cancer nurses are here if you need information or just want to talk. They can help you to understand your diagnosis and what to expect, send you information and tell you about our services.
Grading metastatic prostate cancer
If you had a biopsy (tissue samples) taken as part of your diagnosis, those biopsy samples would have been sent to the laboratory where the histopathologist would look at them. The grade is based on the amount of abnormal cells that are seen. The grading system usually used is called the Gleason score.
What is the Gleason score?
The Gleason score is described using a number from 6 to 10. The two most common grades are added together to make the Gleason score. So if the most common grade in the sample is 3, and the second most common grade in the sample is 4, then your Gleason score will be 7 (3+4). However, if only one grade is found, then this grade is added to itself. So if only grade 4 is found, the Gleason score will be 8 (4+4).
Sometimes a prognostic grade group 1-5 is used with the Gleason score.
With metastatic prostate cancer, the Gleason score is usually high and the prognostic grade group is 5.
Continue reading about metastatic prostate cancer
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