In order to ascertain whether the cancer has spread beyond the prostate, imaging tests are often recommended. These are:
This is short for ‘computerised tomography’. It is a test that uses a rotating X-ray beam to scan the body from several angles. This is used primarily to check whether the lymph nodes are enlarged, which is often an indication of whether the disease has spread to these lymph nodes. The amount of radiation is low and is no cause for concern. This test is usually done where there is a possibility of spread of the disease to other organs.
A magnetic resonance imaging scan creates a cross-section of the soft tissues around the selected part of the body by using magnetic fields, and the test is done as a further check to see whether there is any spread outside the prostate. The machines for these scans use a tunnel in which the body is located. Some may find this a little claustrophobic, but the head usually remains clear of the tunnel, so that the patient can see some daylight. The machine can seem rather noisy and the patient is asked to keep as still as possible during the process. It is possible to speak to the radiographer through a microphone/headphone system. The procedure is quite harmless.
This test is to show whether the disease has spread to the bones. A small amount of low dose radio-active material is injected into the arm about three hours before the scan. The scan takes about 45 minutes, and images of any bones showing the disease will show up on the scan. A bone scan will not usually be done unless the PSA score is greater than 10 and biopsy samples indicate a high-grade cancer. It is painless and quite harmless.
A bone mineral density test (BMD), sometimes called a DEXA scan (dual energy X-ray absorbtiometry) measures bone mass, helps determine bone strength, and can predict the risk of future fracture. It may be requested from the GP before long-term hormone treatment in order to establish a baseline value, and on completion of the course.
This is an examination of the bladder by passing a thin flexible tube through the urethra. It is occasionally recommended to eliminate any possibility of bladder disease.