A prostate nodule is any growth on the prostate which can be felt upon a digital rectal examination. Characterized as hard, soft, smooth or gritty, prostate nodules or the thickening in some portions of the prostate often develop as men grow older.
The evaluation for a prostate nodule may be included in the evaluation for prostitis or a possible infection. As a rule, all prostate nodules found require further evaluation to rule out the possibility of cancer, which may come without any other symptom.
Benign Prostate Nodules
A nodule does not automatically mean that cancer is present. Hard, rocky nodules may indicate calcification or a case of benign prostatic hyperplasia, where the epithelial and prostatic stromal cells multiply and grow large enough to form large nodules around the periurethral region of the prostate. Surgical removal is often necessary if the nodule has grown large enough to block the urethral canal and cause problems with urination. Sometimes, after a PSA test has shown borderline or elevated levels and there is presence of an infection, the doctor may initially put the patient in antibiotics for 2 to 4 weeks, after which the tests are repeated. If all tests are normal within this time, cancer can be ruled out, although a repeat exam is needed in 3 to 6 months.
Cancerous Prostate Nodules
About 50% of prostate nodules are malignant. Although a digital rectal examination cannot determine whether a nodule is cancerous or not, a biopsy can. A biopsy often follows when the doctor finds abnormal results from a Prostate Specific Antigen test. Once the biopsy has revealed cancer, important variables which are then taken into consideration will include grading and staging. Grading of the cancerous prostate nodule makes use of the Gleason score, which determines the degree of abnormality of the prostate cells from 2 (least aggressive) to 10 (most aggressive).
Staging, on the other hand is done on the basis of the DRE. A cancerous nodule is staged as follows:
T1c (PSA detected)
T2a (small prostate nodule)
T2b (larger prostate nodule)
T3 (very large prostate nodule with probable spread outside of the prostate)
T4 (prostate cancer spreading into adjacent organ such as the bladder)
Prevention And Treatment Of Prostate Nodules
There is no known cause why the prostate tends to enlarge as men get older, and why some men found to have prostate nodules develop prostate cancer and some don’t. Experts think genes and diet may play a role. Good nutrition may contribute to overall prostate health. Men who eat fruits and vegetables, foods that naturally contain antioxidants like lycopene and minerals like selenium lowered their risk for the disease significantly.
For men in their forties or older, an annual DRE may be necessary, especially for high-risk individuals. In some cases, whether the nodule is benign or malignant, surgical excision or complete removal of the nodule may become necessary.
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