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There are several different types of prostate cancer tests that are used to diagnose or screen for the disease. The digital rectal exam and a blood test for a substance called “prostate-specific antigen” are the two most common initial prostate cancer tests. If either of these two tests yields abnormal results, the diagnosis must be confirmed by more sophisticated testing including a prostate ultrasound and biopsy, cystoscopy, magnetic resonance imaging (MRI) or computerized tomography (CT). If a diagnosis of prostate cancer is confirmed, a medical professional will assign the cancer a stage from I to IV.
Typical initial and routine prostate cancer tests are the digital rectal exam and a prostate-specific antigen test. During a digital rectal exam, the medical provider will insert his or her lubricated finger into the patient’s rectum and examine the prostate. The doctor is looking for abnormalities in the shape, size and texture of the prostate gland.
A prostate-specific antigen test begins by drawing a blood sample from a vein in the patient’s arm. The sample is analyzed for prostate-specific antigens that the prostate gland produces naturally. A small amount of these antigens are normal; a high level usually indicates prostate inflammation, infection, enlargement or cancer.
If either initial screening test produces abnormal results, the patient will have to undergo further prostate cancer tests to confirm a diagnosis. An ultrasound or a prostate biopsy are often the next step. During a transrectal ultrasound, a small cigar-shaped probe is inserted into the patient’s rectum and the sounds waves it produces create a picture of the prostate gland.
A transrectal ultrasound is less invasive than a prostate biopsy. The doctor will insert a thin needle into the prostate to collect a cell sample. The cells are then analyzed to determine whether or not they are cancerous. If they are cancerous, the cells are compared with healthy prostate cells to determine how aggressive the cancerous cells are. Cancerous cells are given a Gleason score ranging from 2 (non-aggressive) to 10 (extremely aggressive).
If cancer is present, additional prostate cancer tests may be performed to determine if and how far the cancer has spread. Imaging tests like a bone scan, ultrasound, CT scan or MRI are typically used for this purpose. These prostate cancer tests are usually only ordered if the doctor believes that the cancer has spread beyond the prostate gland.
There are four stages of prostate cancer that determine treatment options. In the first stage, the cancer is confined to a small area and cannot be felt by a medical professional. If the cancer is confined to the prostate gland but can be felt, it is Stage II. Stage III cancer has spread to nearby tissues while Stage IV cancer has spread to lymph nodes, bones, and organs. No treatment may be necessary for Stage I but more advances stages can require radiation or hormone therapy, high-intensity ultrasound or chemotherapy.
The majority of prostate cancer cases are discovered during routine screening. Most men begin routine screenings in their 50s. Men who have a high risk of developing this cancer may begin routine screening sooner. Some medical organizations advise against screening procedures; each individual can discuss the risks and benefits of screening with his or her medical provider.