Prostate Cancer

What to Expect from a Prostate Ultrasound

The prostate gland is a small part of the reproductive system in the male body. The gland also forms part of the urinary tract. It’s primary is to produce a fluid that combines with sperm, know as semen.

The prostate gland sits just beneath the bladder neck surrounding the urethra. Since the urethra runs through the prostate gland, problems with the prostate can cause issues with the urinary tract too.

Several conditions can affect prostate1. Symptoms can affect both reproductive health and the urinary tract of the male patient. Men who present with symptoms associated with a prostate-related disease may be advised to undergo a prostate ultrasound.

We consider the purpose of a prostate ultrasound in this post. We will also discuss the appropriate steps men should take to prepare for this procedure.

Issues That Can Be Detected By A Prostate Ultrasound

Men advised to undergo a prostate ultrasound should understand what the test is used for. A doctor may suggest this test when a PSA test reveals high levels of PSA in the man’s blood.

In some cases, a man may also be advised to undergo a prostate ultrasound when a rectal exam revealed something that the doctor suspects to be more serious. Due to the prostate gland function, certain conditions detectable through this test can be severe.

What Does A Prostate Ultrasound Test For?

The primary purpose of an ultrasound is to help a doctor detect the presence of specific problems that affect the prostate. Prostate tissue is analyzed during the procedure. The ultrasound will create live feedback on images of the prostate gland.

Ultrasound is sometimes used to assist with prostate cancer detection. This particular test may also be useful in detecting a condition known as benign prostatic hyperplasia.

The condition is also known as an enlarged prostate. Even though not considered a serious concern like cancer, an enlarged prostate can still cause unpleasant symptoms. Untreated, the condition may lead to complications with the bladder and urinary tract.

Abnormal growths of the prostate gland can be detected with the use of a prostate ultrasound.

In some cases, a prostate ultrasound can also be suggested when a man has difficulty reproducing. In such a case, a doctor will specifically look for factors that may be a cause behind the male patient’s infertility. A transrectal sonography2 is also sometimes advised for a patient suspected to have a prostate-related condition.

Why Might You Need A Prostate Ultrasound?

There are several reasons why a patient might need to undergo a prostate ultrasound.

Some scenarios that may call for a prostate ultrasound could include:

  • A man may have a PSA test done. This is a blood test that detects PSA – an elevation of this compound in the blood has been linked to certain conditions. One of these conditions would be prostate cancer. When a man has an elevated PSA level, then a prostate ultrasound might be used to see if there is an abnormal growth in the prostate gland. The ultrasound can help to reduce the risk of an unnecessary biopsy.

  • When something unusual is felt during a digital rectal examination, an ultrasound test may also be needed. This examination is performed during a routine health exam. A routine prostate cancer screening also includes a digital rectal exam. The nodule may be a sign of benign prostatic hyperplasia. It could also be a sign of something else, such as prostate cancer cells.

  • Men with difficulty urinating may also require a prostate ultrasound. Urinary symptoms are often a sign of an enlarged prostate. In some cases, these symptoms may also be linked to other conditions that affect the prostate.

It should be noted that ultrasound is sometimes used in other scenarios too. A man who needs to undergo a biopsy procedure of their prostate may require ultrasound. The test provides real-time imaging, making it a useful companion for a surgeon performing a biopsy.

What Issues Can Be Ruled Out Through A Prostate Ultrasound?

An ultrasound is not only crucial for the detection of a particular prostate-related condition. It can sometimes be used as a tool to rule out certain conditions that may affect the prostate gland.

One of the most critical conditions that may sometimes be ruled out through ultrasound is prostate cancer. While prostate cancer will be localized to the prostate gland in most men, there are cases where the disease spreads to other areas of the body. Thus, ruling out prostate cancer is critical when it comes to the use of a prostate ultrasound.

Prostatitis and benign prostatic hyperplasia may also be ruled out through an ultrasound. These conditions cause swelling in the prostate. The gland may become enlarged when a man has benign prostatic hyperplasia.

Importance Of A Prostate Ultrasound For Early Detection

Men need to realize the importance of early detection. This is especially the case when it comes to the diagnosis of prostate cancer. Several tests can assist in the early detection of prostate cancer. A rectal exam is often what first identifies an abnormality with the prostate gland.

Following this type of finding, PSA testing will often be advised. At this point, levels of PSA in the blood are identified through a special blood test. A Gleason score test may also be requested.

A biopsy is often advised. An ultrasound-guided biopsy is preferred recently, but a standard prostate ultrasound may be utilized first. Even though some men may find the procedure somewhat uncomfortable, it is crucial to understand the importance of the test.

How Soon Can A Prostate Ultrasound Detect Prostate Cancer?

A critical factor that men need to note is that early-stage prostate cancer will often not cause noticeable symptoms. This is why the disease is only detected at a later stage in some men.

With this in mind, early detection becomes a priority. Early detection is possible through routine screening for prostate cancer. This is a procedure that men are advised to undergo regularly.

One thing that should be noted here is that an ultrasound is not usually part of a routine prostate screening routine. Instead, a doctor will rather conduct a digital rectal examination on the patient. This would allow the doctor to identify abnormalities with the prostate gland.

In cases where ultrasound is used after identifying such abnormalities, the ultrasound can sometimes help in detecting prostate cancer during an early stage.

There is a common concern regarding the overtreatment of prostate cancer3. This is often due to the diagnosis of prostate cancer without proceeding with all the recommended tests. Thus, the results of an ultrasound test can signal the presence of prostate cancer.

It can also provide a radiologist with details on how large of a tumor is affecting the prostate gland in the patient. This can help to determine the severity of prostate cancer. With this in mind, appropriate treatment may be provided to reduce the risk of overtreatment.

What Is The Role Of Prostate Ultrasound In Early Detection Of Prostate Cancer?

There are almost 200,000 new cases of prostate cancer reported in the United States each year4. Apart from new cases, more than 30,000 men die from this cancer every year. This is just in the US alone.

In about 90% to 95% of cases, prostate cancer is localized to the prostate gland. This type of prostate cancer is easier to treat. In other cases, a more aggressive type of prostate cancer is found. In such a scenario, cancer spreads to other areas of the body. This is a fatal type of prostate cancer. Without early intervention, the patient is at a high risk of life-threatening complications.

A prostate ultrasound can sometimes help detect prostate cancer during an early stage. This may be the case for both localized and metastatic prostate cancer. When detected early, treatment can be initialized before prostate cancer causes fatal complications.

Prostate ultrasound can also reduce the risk of unnecessary treatment. There are cases where aggressive treatment is provided to a patient with a mild form of early-stage prostate cancer. By detecting tumor growth through an ultrasound, a radiologist will gain a better idea of how severe the tumor is. This provides the data needed to offer appropriate treatment to the patient. It also ensures a patient is not given too invasive procedures for a milder form of cancer in their prostate gland.

Thus, ultrasound plays multiple roles in prostate cancer diagnosis. It helps to ensure prostate cancer can be detected early on. The test also ensures appropriate treatment can be offered to the patient. Furthermore, an ultrasound test would also help to reduce the need for unnecessary procedures.

This may include the use of a biopsy. When an ultrasound does not show any signs of tumor growth, the use of a biopsy may be prevented. This can be the case when the abnormality with the prostate gland is linked to benign prostatic hyperplasia.

In such a case, a biopsy may not be needed. PSA levels may still be somewhat elevated. Thus, skipping the ultrasound and only opting for a biopsy leads to an unnecessary invasive procedure.

How Can Early Detection Of Prostate Cancer Affect Treatment And Recovery?

There are certain benefits that early detection of prostate cancer offers. The primary area of concern is related to the treatment of prostate cancer. Similarly, the recovery process can be affected too.

When prostate cancer is not detected at an early stage, the disease may become more aggressive. At this point, the surrounding tissue in the pelvic region may be affected by cancer. In some cases, aggressive prostate cancer develops. This is when cancer spreads to other areas of the patient’s body.

Treatment for cases where cancer spreads is more invasive than what is used to treat early-stage prostate cancer. The treatment would also cause more concerning side effects in the patient. This means the patient will also require more time to recover from both the disease and the treatment used.

Early treatment would, of course, be less invasive. When treatment is provided during an earlier stage of prostate cancer, then it also yields more successful results. The patient would be able to recover from the disease faster too.

How A Prostate Ultrasound Is Performed

Men should also understand how the procedure works. This is important, as it allows the man to be better prepared when they undergo a prostate ultrasound. Whether the process is used to detect prostate cancer or benign prostatic hyperplasia, the procedure tends to be very similar.

First of all, a man should understand what the purpose of the ultrasound is for. The use of ultrasound can differ based on its purpose. An ultrasound may be used to look at the prostate volume. This is used as a diagnostic tool. In some cases, the ultrasound-guided biopsy is used too.

A transperineal biopsy or standard prostate biopsy uses ultrasound differently. Both, however, can assist in the process of diagnosing prostate cancer5. Similarly, they can also help identify an enlargement in prostate tissue.

Where Is A Prostate Ultrasound Typically Done?

The first question that a lot of men have is where the ultrasound will be conducted. The location of the prostate gland makes it challenging to perform an ultrasound from the surface area of the skin. Thus, an ultrasound probe generally needs to be inserted into the male patient’s rectum. This is the most appropriate location for the prostate ultrasound to be conducted.

In such a case, the test is called transrectal ultrasound. The same location may be used if a biopsy is needed in the patient. A biopsy may be advised if the imaging results suggest something unusual with the patient’s prostate.

What Happens During A Prostate Ultrasound?

The male patient will generally be asked to lie on their side when a prostate ultrasound is performed. The patient also needs to bend their knee. This provides better exposure of the prostate when a transrectal ultrasound is performed.

A transducer will be used during the procedure. The transducer sends out ultrasonic waves into the patient’s body. The same device is capable of reading the way that the waves hit organs and tissue inside the body.
A protective layer covers the transducer. This is a disposable cover. The cover will be disposed of when the patient’s ultrasound has been completed. The cover is lubricated. It is then inserted into the rectum through the male patient’s anus.

The transducer may be slightly moved during the ultrasound test. This allows the doctor to get a view from different angles. These angles can provide better imaging results. It allows a radiologist to make a more accurate finding. This helps with the diagnostics process.

When a biopsy is performed, a similar procedure may be used. The ultrasound will provide real-time imaging on the screen. This allows the doctor to see exactly where the needle should be placed to retrieve a small sample of prostate tissue.

A doctor will generally refer to a male patient to a specialist when there may be a need for further diagnostics. It is also important to realize that a radiologist is needed to examine the findings of the ultrasound images. Several still images are taken of the prostate gland during the procedure. These images are provided to the radiologist. They will provide comments on their findings, which can then be reviewed by the healthcare provider who referred the patient for the prostate ultrasound.

How To Prepare For A Prostate Ultrasound

Ultrasound imaging of prostate tissue is a relatively simple procedure. Still, men should know how they can best prepare for the entire process. This helps to make the man more comfortable while they are undergoing the procedure.

There are not too many steps that a man can take to prepare for the procedure. There are, however, a few things that a man can do to make the entire procedure less inconvenient for themselves.

What Do You Need To Do Before Your Prostate Ultrasound?

We should start with a few things that a man should do before they visit the center where the ultrasound will be performed. One important factor is to ensure the patient wears comfortable clothing. It is generally advised for the male patient to wear loose-fitting clothes. This ensures nothing will get in the way during the prostate ultrasound.

There are some cases where the patient will be asked to remove their clothing. Men should consider leaving any jewelry at home. Jewelry may sometimes get in the way. If the man wears jewelry, they may be asked to take it off before the procedure is initiated.

The doctor may ask the man to take an enema. The enema will be used about two hours before the ultrasound test. This helps to clean the bowels of the man and ensures a smoother process when the ultrasound is conducted. A laxative is sometimes provided instead of an enema.

Other than this, a man may also want to avoid eating too close to the test. Food may be restricted for a few hours before the patient undergoes the ultrasound test.

Additional preparation steps may be required when a biopsy is done. This will generally be to help avoid complications from the procedure.
In some cases, a doctor may provide a patient with a sedative. Ativan is commonly prescribed to the patient. The sedative should be taken at an appropriate time before the procedure is conducted to reduce anxiety in men. It also helps the patient relax during the procedure.

Preparation may also include getting someone to drive the patient back home. This will generally be the case when the patient is given a sedative. The mechanism of the sedative could interfere with the patient’s ability to drive themselves home after the procedure.

Mental preparation is also important when undergoing a prostate ultrasound. The test is conducted following other testing procedures. Thus, the man may be at risk of prostate cancer. In some cases, counseling may be a helpful strategy to help a man prepare for the results that may be found during the ultrasound test. This can also help the patient better cope with the results provided to them after they have undergone the test.

Conclusion

Color Ultrasound is safe, painless, and inexpensive. Unlike other screening methods, they can be repeated as often as necessary to monitor areas of concern closely and assess treatment efficacy. For these reasons, sonograms are a more effective alternative to biopsies in detecting prostate tumors

Sources

  1. Journal of Collegium Antropologicum. (2010) Transrectal sonography in prostate cancer detection – our 25 years experience of implementation. [online] Available at: https://www.ncbi.nlm.nih.gov/pubmed/21305738
  2. American Cancer Society. Can Prostate Cancer Be Found Early? [online] Available at: https://www.cancer.org/content/cancer/en/cancer/prostate-cancer/detection-diagnosis-staging/detection.html
  3. American Cancer Society. Key Statistics For Prostate Cancer. [online] Available at: https://www.cancer.org/cancer/prostate-cancer/about/key-statistics.html
  4. Centers for Disease Control and Prevention. How Is Prostate Cancer Diagnosed? [online] Available at: https://www.cdc.gov/cancer/prostate/basic_info/diagnosis.htm
  5. Oregon Health & Science University. (2005) Presence Of High-Risk Prostate Cancer Can Be Predicted Without A Biopsy, New Study Says. [online] Available at: https://www.sciencedaily.com/releases/2005/05/050522112707.htm

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