Diagnosis and Screening for Prostate Cancer
How is prostate cancer diagnosed?
The most common ways to screen for prostate cancer are a physical evaluation and checking your PSA (prostate-specific antigen) levels:
- Digital rectal exam is when your doctor puts a gloved, lubricated finger in your rectum to feel your prostate. This is the most common way to check for prostate cancer.
- PSA blood test that shows higher than normal PSA levels may mean you have prostate cancer. High PSA levels can also point to an enlarged or infected prostate gland.
Several noncancerous conditions can cause an enlarged prostate and/or elevated PSA levels. PSA levels can also vary from person to person and change with age. Your doctor will recommend additional testing before he or she can make an accurate prostate cancer diagnosis.
If your PSA is high, or if your doctor finds anything during the rectal exam, he or she may schedule a biopsy. During a biopsy, your doctor takes a sample of tissue from your prostate gland and sends it to a lab for testing. A biopsy is the only way to diagnose prostate cancer. However, other tests may be used prior to a biopsy to better understand your risk of prostate cancer. These tests can include advanced blood tests and imaging, such as an MRI.
If your are diagnosed with prostate cancer, your doctor will then evaluate the extent of your cancer based on your examination findings, your PSA and the grade of your cancer. This information will guide your prostate cancer treatment plan.
The grade of cancer evaluates how healthy the tissue looks based on samples taken from different areas. Less aggressive tumors tend to look more like healthy tissue and receive a low score. Pathologists assign a higher score to cancer cells that look more aggressive. The scoring system used is a scale from 1 to 5, with 5 being the most aggressive.
Doctors also stage prostate cancer according to a system that’s more complex than other types of cancer staging. Your doctor will consider several factors to determine the stage of your prostate cancer:
- Size of your primary tumor
- Whether the cancer has spread to nearby lymph nodes
- Whether the cancer has spread to other areas of the body or different organs
- Your PSA level
- Your Gleason score