Doctors use three main tests to diagnose prostate cancer.

Early cancers are usually picked up by a blood test, called a PSA test, which is sometimes performed as part of a routine health check.

However, not all doctors agree that it's a good idea to have a PSA test. This is because research hasn't shown that men who are screened are less likely to die from prostate cancer than those who aren't.

 

 

 

 

 

Source:
Lin K, Lipsitz R, Miller T, et al.
Benefits and harms of prostate-specific antigen screening for prostate cancer: an evidence update for the U.S. Preventive Services Task Force.
Annals of Internal Medicine. 2008; 149: 192-199.

 

 

 

 

 

¹ Also, PSA tests aren't fail-safe, and studies have found that men can have significant distress for up to a year if a test falsely shows they may have cancer.

 

 

 

 

 

Source:
Lin K, Lipsitz R, Miller T, et al.
Benefits and harms of prostate-specific antigen screening for prostate cancer: an evidence update for the U.S. Preventive Services Task Force.
Annals of Internal Medicine. 2008; 149: 192-199.

 

 

 

 

 

¹ A panel of doctors that reviewed all the studies has concluded that there isn't yet enough good research on PSA screening to say whether men should or shouldn't be screened for prostate cancer.

 

 

 

 

 

Source:
U.S. Preventive Services Task Force.
Screening for prostate cancer: U.S. Preventive Services Task Force recommendation statement.
Annals of Internal Medicine. 2008; 149: 185-191.

 

 

 

 

 

²

If you are considering having the test, here are some points to keep in mind.

 

 

 

 

 

Source:
Wilt TJ.
Prostate cancer screening: practice what the evidence preaches.
American Journal of Medicine. 1998; 104: 602-604.

 

 

 

 

 

³

If you've already had treatment for prostate cancer, your doctor may recommend that you have regular PSA tests to check that the cancer has not come back or grown.

Another test that doctors use to check for prostate cancer is called the digital rectal exam (DRE). If your tumor is bigger than half an inch (around 1.5 centimeters), your doctor may be able to feel it through the wall of your

 

 

 

 

 

rectum
The rectum is the last six to eight inches of the large intestine, ending with the anus (where you empty your bowels).

 

 

 

 

 

rectum.

Wearing a medical glove and using a lubricating gel to make the exam more comfortable, your doctor will put a finger into your rectum to feel for a lump. This doesn't hurt, but some men find it embarrassing.

A biopsy is the main test doctors use to find out for certain if you have cancer. The doctor uses a special needle to remove very small pieces of tissue from your prostate to look at under a microscope. The needle is either gently pushed through the wall of your rectum into the prostate or it is inserted into the skin between your scrotum (the sac that holds your testicles) and your anus (the opening through which you empty your bowels). The needle is guided by a special device called an

 

 

 

 

 

ultrasound probe
Ultrasound is a tool doctors use to create images of the inside of your body. An ultrasound machine sends out high-frequency sound waves, which are directed at an area of your body. The waves reflect off parts of your body to create a picture. Ultrasound is often used to see a developing baby inside a woman's womb.

 

 

 

 

 

ultrasound probe.

A biopsy is not usually painful, but you may feel a sharp prick, even if you are given a

 

 

 

 

 

local anesthetic
Local anesthetic is a painkiller for one area of your body. You usually get it as a shot. It makes that area numb. An example is the novocaine you get when your dentist fills a cavity.

 

 

 

 

 

local anesthetic (painkiller) to numb the area.

The more abnormal the cancer cells look compared with healthy prostate cells, the more likely the cancer is fast-growing (aggressive) and able to spread.

Most of the time, doctors will know if your cancer has spread by looking at a combination of your PSA level and your biopsy results. If they need more information about your cancer, doctors can use special techniques to look at other parts of your body, including your lymph nodes and your bones. They may use

 

 

 

 

 

ultrasound probe
Ultrasound is a tool doctors use to create images of the inside of your body. An ultrasound machine sends out high-frequency sound waves, which are directed at an area of your body. The waves reflect off parts of your body to create a picture. Ultrasound is often used to see a developing baby inside a woman's womb.

 

 

 

 

 

ultrasound scans, X-rays or body scans (

 

 

 

 

 

CT scan
A CT scan is a type of X-ray. It takes several detailed pictures of the inside of your body from different angles. CT stands for computed tomography. It's also called a CAT scan (computed axial tomography).

 

 

 

 

 

computed tomography and

 

 

 

 

 

MRI scan
The magnetic resonance imaging (MRI) machine uses a magnetic field to create detailed pictures of the inside of the body. These pictures allow doctors to look at parts of the body in three-dimensional images.

 

 

 

 

 

magnetic resonance imaging) to check whether cancer is anywhere else in your body.

From the results of your tests, you doctor will be able to tell you:

Doctors use number and letter classification systems to describe how far your cancer has spread. This is called staging. There are several systems, but the most common is called the TNM system. See our explanation of the TNM system to find out what the different classifications mean.

Doctors use something called the Gleason score to describe how your cancer looks under a microscope. This is called your cancer grade. A tumor that has a low-grade score is likely to be slow-growing, while one with a high-grade score is more aggressive and likely to spread. If your cancer has been given a grade, read our explanation of the Gleason score to learn more about what it means.

Your doctor may combine your TNM classification and Gleason score to tell you the overall stage of your cancer. Knowing this stage can help you and your doctor consider what may happen to you, and it can help you decide on the best course of treatment.

There are four stages of prostate cancer. Stage 1 is the earliest, stage 4 is the most advanced. See Defining your cancer's overall stage to learn more.

 

 

 

 

 

Source:
Scher HI.
Hyperplastic and malignant disease of the prostate.
In: Braunwald E, Hauser SL, Fauci AS, et al. Harrison's principles of internal medicine. 15th ed. McGraw Hill, New York, U.S.A.; 2001.

 

 

 

 

 

⁴

 

 

 

 

 

Source:
Carroll PR, Lee KL, Fuks ZY, et al.
Cancer of the prostate.
In: DeVita VT, Hellman S, Rosenberg SA. Cancer: principles and practice of oncology. 6th edition. Lippincott, Williams and Wilkins, Philadelphia, U.S.A.; 2001.

 

 

 

 

 

⁵

 

 

 

 

 

Source:
Bannister LH.
Accessory glandular structures.
Berry MM, Collins P, Dyson M, et al. In: Gray's anatomy. 38th edition. Churchill Livingstone, Edinburgh, UK; 1995.

 

 

 

 

 

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