Making the Diagnosis
There is a screening test for prostate cancer called the prostate-specific antigen (PSA) test. PSA is made by prostate cells, and all men have PSA levels that can be detected in the blood. Men with prostate cancer often have more PSA. High PSA levels can also occur with noncancerous conditions, and PSA may be low in people with prostate cancer. Therefore, repeat testing may be done to confirm the results. If high PSA levels are found repeatedly, doctors may suggest taking a biopsy. As people age, PSA test may become less reliable in identifying prostate cancer. You should discuss with your doctor about whether you require PSA testing.
Another test a doctor can do is a digital rectal exam (DRE), which involves feeling the prostate with a gloved finger. If there is a high PSA level, or a lump is felt, small tissue samples will be taken from about 6 to 8 locations in the prostate with the use of a biopsy gun. The doctor guides the biopsy gun with the aid of a transrectal ultrasound (TRUS), a device that creates an image of the prostate. The doctor will also want a biopsy sample of the lymph nodes to check if the disease has spread. You may have short periods of sharp pain during this procedure. Sometimes, doctors will freeze the area to help reduce the pain.
If cancer is found, a specialist (usually a urologist) will determine the size, stage, and grade of the tumor. This information will help determine which therapy may be used to treat the cancer.