Raised or rising PSA - what happens next? > Outcomes
Partin's tables
Although all the tests described seem very ‘high tech’ and sophisticated, unfortunately they do not always give a very precise answer to the question ‘has the cancer spread beyond the gland’? In fact the so-called ‘Partin's tables’, which compare the findings of the rectal examination, the PSA level and the Gleason score, are still the best way of estimating the risk of spread beyond the prostate capsule.
These tables were developed by Dr Alan Partin, now the Professor of Urology at Johns Hopkins University Hospital, Baltimore, USA. He has shown that the smaller the cancer feels on rectal examination, and the lower the PSA level and Gleason score, the greater the likelihood that the cancer can be completely removed by surgery. These tables can therefore be useful in helping the doctor, patient and family decide together on the best treatment option.
Receiving bad news
Of course, being told that you are suffering from prostate cancer will come as a major shock. In an instant your usually optimistic prospects for the future are transformed. The blow can be lessened, however, if the news is broken sensitively and sympathetically, in the presence of your partner or a close friend, by a caring and informed professional who gives you as much time as you need.
Often nowadays, the consultation with the doctor who delivers the news about the biopsy results is followed immediately by an interview with a urology nurse specialist. This specialist nurse will help to answer any further questions you might have and provide written material about the disease and its treatment. This can be invaluable, because many patients retain only a fraction of the information they are given after the shocking news of a cancer diagnosis. The specialist nurse will also provide details of sources of support from charities, such as the Prostate Research Campaign UK and Cancerbackup, as well as details of patient support groups. (You can also find details of other sources of help in the section on further information and support.)
Although the news may not be what you had hoped for, remember that the outlook for men with prostate cancer is now generally good and, with all the current research effort, is improving all the time.