Genetic Markers. Researchers have identified a genetic marker (EZH2), which may prove to be an important marker for aggressive prostate cancer. It may, in fact, prove to be a better predictor of outcome than the tumor grade, stage, or surgical margins. Other genes beings studied are those that regulate tumor growth (p53, p27, bcl-2).
Other Markers. Other markers being investigated for predicting cancer progression include prostate-specific membrane antigen, prostatic acid phosphatase, and growth factors.
Nuclear Imaging Tests
The ProstaScint is a scanning technique that uses tiny amounts of radioactive material with a monoclonal antibody that can attach specifically to prostate cancer cells. A special camera then can detect tumor cells that cannot be detected with other diagnostic tools. It may be effective in helping doctors make better treatment decisions. The role of this test in the routine management of prostate cancer is still being defined.
Tests for Metastasis
If the biopsy indicates cancer, the doctor will order other tests to determine whether or how far the cancer has spread.
Bone Scans and X-Rays. Bone scans and X-rays may reveal whether the cancer has invaded the bones. To perform a bone scan, doctors inject low doses of a radioactive substance into the patient's vein, which accumulates in bones that have been damaged by cancer. A scanner then reveals how much of the radioactive material has accumulated. Arthritis and infections may also produce positive scans. Patients with PSA levels below 20 ng/mL are unlikely to have scans that show cancer in the bone.
Computed Tomography and Magnetic Resonance Imaging. Computed tomography (CT) or magnetic resonance imaging (MRI) scans can further pinpoint the location of cancer that has spread beyond the prostate. Advanced MRI techniques are showing promise for staging and planning treatments.
 | Click the icon to see an image of a CT scan. |
 | Click the icon to see an image of a MRI. |
Bone Metastasis Markers. Researchers are investigating chemical markers, such as a amino-terminal propeptide of type I procollagen (PINP), as early indicators of bone metastasis.
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