How Prostate Cancer Is Diagnosed

There are several ways that physicians can detect and diagnose prostate cancer. Because prostate cancer can present few to no symptoms until it spreads to other parts of the body, it’s normally discovered during routine exams. These exams are generally recommended for men beginning at age 40, although those with a higher risk for prostate cancer should undergo regular testing at an earlier age.

Exams and Tests

The most widely used methods for detecting prostate cancer are rectal exams and blood tests. In a rectal exam, your doctor will insert a finger into your rectum and feel the prostate for irregularities. In a blood test, your blood will be drawn and checked for a protein called prostate-specific antigen, or PSA. If you have elevated levels of PSA in your blood, or if a rectal exam shows irregularities, your doctor will usually order a prostate biopsy to check for cancer.

Another less common test is the transrectal ultrasound or TRUS. For a TRUS, your doctor will insert a small probe into your rectum. This probe gives off ultrasound waves, allowing a computer to create a digital image of your prostate.

Prostate Biopsies

For a biopsy, your doctor will use a needle to take samples of your prostate, using local anesthetic to prevent pain. The needle is usually inserted through the urethra or perineum, sometimes with the assistance of a transrectal ultrasound. After a biopsy, you will usually be prescribed an antibiotic to lower your risk of infection.

Your doctor may not find cancer in your biopsy but still identify abnormal cells. In these cases, your doctor may decide to biopsy your prostate again in a couple months, depending on how abnormal the cells are.

The Gleason System

Stages of prostate cancer are evaluated using the Gleason Grading System. The scale uses numbers one through five to describe the cancer’s severity based on how similar the cells in a cancerous area are to healthy cells. Grade 1 means the cancerous cells look very similar to regular cells and Grade 5 means the cancer cells look very different from regular cells.

Prostate cancer can affect different areas of the prostate in various stages, and the Gleason grades from differently affected areas will be added to get an overall Gleason score. The higher your Gleason score is, the higher the likelihood of your cancer spreading quickly.

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Posted on May 5, 2023