How is Prostate Cancer Diagnosed?

When Should I Get Tested?

Deciding to get tested is a personal decision made after a consultation with a doctor. Some important factors to consider are your age, race, family history, and history of exposure. For example, exposure to Agent Orange, other defoliants, or pesticides can be a factor.

All men are at risk of prostate cancer, so it is important to talk with your doctor to make an informed decision. Detecting prostate cancer early gives you the best chance of living longer. In fact, more than 99 percent of men survive prostate cancer when it is caught early.

How Do I Get Tested?

A general practitioner or an urologist can perform a full prostate cancer exam. This would usually include a PSA blood test and digital rectal exam, also called a DRE.

A Prostate Specific Antigen (PSA) test measures the level of PSA in the blood. PSA is a substance made by the prostate. The levels of PSA in the blood can be higher in men who have prostate cancer. The PSA level may also be elevated in other conditions.

A Digital Rectal Exam is a test that is done when a doctor or nurse inserts a gloved, lubricated finger into the rectum to estimate the size of the prostate and feel for lumps or other abnormalities.

Talk to your general doctor or urologist about receiving a prostate exam. If you do not have a doctor, do not have insurance, and cannot afford a test, contact us to find out what free screenings are available in your area. Many screenings occur in September, during Prostate Cancer Awareness Month.

Recent research has yielded additional tests that – in addition to the PSA and subsequent DRE (Digital Rectal Exam) and Biopsy – that can give a doctor more information on to determine the probability of both finding cancer during a biopsy and determining how aggressive that cancer is likely to be.

Watch prostate cancer experts, Dr. Lowentritt and Dr. Siegel in this video discuss early detection:

What if My Test Results Are Abnormal?

If the results of early detection tests like the PSA test or the digital rectal exam suggest that you might have prostate cancer, your doctor will conduct further testing. The PSA may be repeated, or you may be sent to a specialist for more tests such as a transrectal ultrasound and a prostate biopsy.

In a prostate biopsy, a tissue sample is taken from your prostate. Cancer can only be diagnosed with a tissue sample.

In addition to a PSA test, DRE (Digital Rectal Exam), and a biopsy, research has yielded additional tests that can detect if cancer is present, and if so, how aggressive that cancer might be:

  • Phi
    • The Prostate Health Index combines three blood tests that give a more accurate “Phi Score,” which gives accurate information based on a high PSA to better determine the probability of finding cancer during a biopsy.
  • PCA3
    • A urine test that more accurately detects the possibility of prostate cancer by examining the expression of PCA3 – a gene specific to prostate cancer. The PCA3 score is used to determine the need for repeated biopsies. Research has continued for years to look into whether PCA3 can replace or serves as a substitute for the PSA test.
  • 4KScore
    • A blood test providing patient-specific probability of finding an aggressive form of prostate cancer during a biopsy. Doctors and patients can then make an informed decision on whether to have a biopsy. The test measures total PSA, free PSA, Intact PSA and for certain enzymes called kallikrein. An algorithm used with the patient’s age and physical exam gives a probability percentage of having aggressive disease.

What if I Am Diagnosed with Prostate Cancer?

Many people have been where you are standing. Don’t lose hope. More than 2.9 million American men have been diagnosed with prostate cancer and are alive today.

The first thing you should consider doing is to find out about the specifics of your cancer. You should know your stage (location and extent of the tumor) and grade (also known as Gleason score, a measure of the tumor’s aggressiveness).

From there you can find out what treatment options you want to pursue, if any. Talk to your doctors. Choose a healthcare team of different specialists, or consult a second opinion. You can also do your own research, or talk to men who have been in your position. Many of our advocates are patients and survivors.