Screening and Diagnosing Prostate Cancer

Oftentimes prostate cancer does not cause symptoms, so screening is vital to ensure the disease is detected early when treatment is most likely to be effective. Starting at age 50, or earlier if you’re at high risk, schedule an annual prostate exam with your doctor.
Some of the screening methods City of Hope uses to detect prostate cancer include:
  • Prostate specific antigen (PSA) test
    A simple blood test to determine if your PSA level is higher than normal. A high PSA reading can be caused by either a benign or cancerous growth of the prostate, or simply by a prostate infection. There is even a chance of having cancer when your PSA level is low.
  • Digital rectal exam (DRE)
    During this procedure, the physician examines the prostate gland by inserting a gloved, lubricated finger into the rectum to check for any evidence of abnormalities in its texture, shape or size. The DRE, along with the PSA test, helps to detect prostate cancer in men who have no symptoms of the disease.
  • Biopsy
    A core needle biopsy is the most common method of diagnosing prostate cancer. Usually, six to 18 biopsy samples are taken from different areas of the prostate. Placing the ultrasound probe into the rectum can be temporarily uncomfortable, but is usually easily tolerated by most men. The biopsies themselves can be uncomfortable.
At City of Hope, our urologists have popularized the use of a local anesthetic prior to obtaining the prostate biopsies, much like the dentist uses when working on your teeth. This local anesthetic alleviates the pain and discomfort of the individual needle biopsies. Since today, most patients have 12 or more biopsies, this advance makes the entire procedure much more tolerable.
  • Transrectal ultrasound of the prostate (TRUSP)
    TRUSP uses soundwaves to create an image of the prostate on a video screen. There is a small probe, which is inserted into the rectum. The prostate is visualized and biopsies can then be taken through the probe while simultaneously imaging the prostate. The procedure takes approximately 10 to 20 minutes.
  • Bone scan
    This X-ray procedure can show whether the cancer has spread from the prostate to the bones. This is not routinely ordered unless there are signs of aggressive disease, such as an elevated PSA, a high Gleason score or localized bone pain.
  • Other radiologic imaging studies may be performed to determine the extent of the tumor and if it has spread. These tests include ProstaScint scan, endorectal magnetic resonance imaging, and/or computed tomography scan.