Prostate Nodule
Home Back Positive Biopsy Prostate Nodule








 Anatomy & Physiology


 Who Should be Evaluated

 Prostate Examination

 Digital Rectal


 Total vs. Free Ratio

How to Evaluate for PCa


 Total vs. Free PSA

 Trans Rectal Ultrasound

 Needle Biopsy

 Biopsy Results

What if the Biopsy is Positive?

Gleason Grade


 Stage A

 Stage B

 Stage C

 Stage D

Therapy Options


 Radical Prostatectomy

 Standard Operation    

 Nerve Sparing Oper.

 Positive Margins

 Recurrence after Surgery

Radiation Therapy

 External Beam Therapy


 Interstitial Radiotherapy

 Brachytherapy or Seeds

 Rapid Interstitial Therapy

 Combined Therapy

 Neoadjuvant Therapy or

         Hormones + Radiation

Combined Therapy


Hormone Therapy 

 Hormonal Therapy


 LHRH Inhibitors

 Total Androgen Blockade

 Neo Adjuvant Therapy or

    Hormones + Radiation


Late Stage Prostate Cancer

 Cycling antiandrogens



 Bony Metastases

   External Beam Radiation

   Strontium 89



   Monoclonal Antibodies

   Alternate Medicine

Alternate Medicine






    A Prostate Nodule is simply a "bump" that can be felt in the prostate on Digital Rectal Examination, (DRE).  A nodule does not mean that prostate cancer is present.  Prostate nodules can be hard, soft, big, small or gritty.  While a rocky hard nodule may mean cancer it may also be a calcification, (stone), in the prostate. Similarly, a soft nodule may be a cancer.  An asymmetric prostate may be considered a nodule.  When a nodule is found, the urologist must include in his evaluation the presence of symptoms of prostatitis or infection, the level of PSA and/or Free PSA, as well as the consistency of the nodule.  On occasion, treatment for infection or prostatitis is given for several weeks to a month and the prostate reevaluated.  If the nodule disappears, and the PSA goes back to normal, a biopsy may not need be done.

    However, if a nodule does not disappear or the PSA does not drop to normal with antibiotic treatment, or especially if there are no symptoms of infection sonography and biopsy MUST be done unless there are medical contraindications such as age over 80, other major life threatening conditions, etc.

    Overall, about 50% of all prostate nodules are cancerous!























    rev: 03/02                              


MidAtlantic Urology Associates LLC

Formerly Werner-Francis Urology Associates LLC

Greenbelt - Bowie - Laurel     Maryland

(301) 477-2000              Fax (301) 474-2389

7500 Greenway Center Drive   Eigth Floor    Greenbelt, MD   20770

A Patient Care Center of Mid Atlantic Urology Associates, LLC


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Rev: 08/07