Prostate Cancer | Diagnosis & Tests

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Learn More About Prostate Cancer Diagnosis & Tests

Pros & Cons of PSA Testing

What is prostate cancer screening?

A prostate cancer screening is a test that your doctor uses to look for prostate cancer before you have any symptoms.

Should I be screened for prostate cancer?

The U.S. Preventive Services Task Force (USPSTF) and the American Academy of Family Physicians (AAFP) recommend against routine prostate cancer screening for all men, regardless of age. Learn why.

What prostate screening tests are available?

Prostate screening tests include:

  • Digital rectal exam (DRE): During a DRE, your doctor will put a gloved, lubricated finger a few inches into your rectum to feel your prostate gland. A normal prostate feels firm. If there are hard spots on the prostate, your doctor may suggest additional testing to check for prostate cancer.
  • Prostate-specific antigen (PSA) test: The PSA test is a blood test that measures the level of PSA in your blood. PSA is a substance produced by the prostate. Men who have prostate cancer may have a higher level of PSA in their blood. However, a PSA level can also be high because of less serious causes, such as infection or prostate enlargement. The USPSTF and AAFP recommend against routine PSA-based screening for prostate cancer. Learn why.

If you choose to be screened for prostate cancer, most doctors will recommend that you have both screening tests. It’s important to remember that these tests only help your doctor determine whether your prostate is healthy. An abnormal screening test result does not mean that you have cancer.

What happens if my screening test results are abnormal?

If your screening test results are abnormal, your doctor may recommend other tests to determine whether you actually have cancer. Those tests may include:

Ultrasound: A transrectal ultrasound provides your doctor with an image of your prostate. During the test, your doctor will insert a small probe into your rectum. This probe sends out sound waves (called ultrasound) that bounce off your prostate gland. A computer uses the sound waves to create an image of your prostate.

Biopsy: A transrectal biopsy is when your doctor removes a very small piece of your prostate to check it for cancer cells. A biopsy is the only 100% sure way to diagnose prostate cancer. During the biopsy, your doctor will insert a needle through your rectum and into your prostate. The needle collects tissue from your prostate. Your doctor may take tissue samples from several different areas of your prostate.

What if my biopsy is normal?

If your biopsy is normal, you do not have prostate cancer. Talk to your doctor about whether another condition may have caused your symptoms or your high PSA level. Ask your doctor about how often you should have checkups.

What if my biopsy is positive for cancer?

If your biopsy results are positive for cancer, the next step is for your doctor to grade and stage the cancer.

  • Grading tells you how aggressive (fast-growing) the cancer is. Cancers with higher grades are more likely to grow and spread than cancers with lower grades. A common system of grading is called the Gleason score. Gleason scores range from 2 (not aggressive) to 10 (very aggressive).
  • Staging tells you how advanced the cancer is, or how far it has spread. To determine the stage, your doctor may order imaging tests such as ultrasound, bone scan, computerized tomography (CT) scan, or magnetic resonance imaging (MRI). Stages I or II mean the cancer was caught early and has not spread outside of the prostate. Stages III and IV mean the cancer has spread to nearby tissues or organs, or to other body parts.

Bibliography

See a list of resources used in the development of this information.

Written by familydoctor.org editorial staff

Reviewed/Updated: 08/12
Created: 01/99

Learn More About Prostate Cancer Diagnosis & Tests

Pros & Cons of PSA Testing

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