Prostate Cancer Tests

Screening and Diagnosing Prostate Cancer

A diagram of the male urinary system includes a representation of the prostate gland. Removal of a cancerous gland is best done by those with much expertise, as at City of Hope.
A diagram of the male urinary system includes a representation of the prostate gland. Removal of a cancerous gland is best done by those with much expertise, as at City of Hope.

Precise prostate cancer tests are crucial for treatment planning, and City of Hope is equipped with state-of-the-art technologies and specialized staff to ensure an accurate, comprehensive diagnosis of prostate cancer.

Highlights of our screening and diagnosis services include:

  • Advanced imaging technologies to detect and locate prostate tumors
  • MRI-guided biopsies to increase precision and accuracy
  • An experienced pathology staff specializing in prostate cancer diagnosis
  • Genomic testing of cancer cells to find the most effective treatments available

How Is Prostate Cancer Detected?

Once you notice symptoms, or as part of a routine examination, your doctor may use the following tests to look for prostate cancer:

  • Physical exam
  • Prostate-specific antigen (PSA) test: This test measures PSA levels in your blood. Levels higher than normal range (4 nanograms per milliliter of blood) may indicate prostate cancer or other conditions, such as prostate inflammation or BPH, an enlarged, noncancerous prostate.
  • Digital rectal exam: A doctor or nurse inserts a lubricated, gloved finger into the rectum to feel for prostate abnormalities.
  • Biopsy: Surgical removal of suspicious tissues for further examination
  • Transrectal ultrasound: A small probe is inserted into the rectum to take images of the prostate using high-energy sound waves. A biopsy may be taken if the images show any abnormalities. This procedure typically takes less than 10 minutes and the area may be numbed to reduce discomfort.
  • Transrectal magnetic resonance imaging (MRI): This procedure images the prostate using a powerful magnet, radio waves and a computer; a radio wave-emitting probe is inserted into the rectum and the MRI machine takes a series of detailed images of the prostate and its surrounding regions. A biopsy may be taken at the same time if the images show any abnormalities.

If cancer is found, additional tests are performed to determine the type and stage of the disease. These diagnostic tests include:

  • Lymph node biopsy: Removal and examination of lymph nodes in the pelvic region to see if cancer has spread
  • Seminal vesicle biopsy: Removal of fluid from seminal vesicles (glands that produce semen) to detect prostate cancer spread
  • ProstaScint scan: A test that uses a small amount of radioactive material, which binds selectively to prostate cancer cells. After the material is injected into the bloodstream, a scanner is used to detect prostate cancer spread, which shows up as bright spots due to the concentration of the material.
  • Computed tomography (CT or CAT) scan: This test involves taking a series of X-ray images at different angles to form a computer-generated image, which determines tumor size, location and number. Special dyes may be used to enhance this scan.
  • Bone scan: A procedure using a small amount of radioactive material to determine if prostate cancer cells have spread to the bones.
  • Genomic testing: The cancerous tissue is tested to see if it exhibits certain genetic mutations, which can be used to determine better treatments.

Based on the results of these tests, the prostate cancer is then staged according to its size, number of lymph nodes affected and whether it has spread to nearby or distant organs.

What Are the Current Screening Guidelines for Prostate Cancer?

The American Cancer Society currently recommends men discuss with their health care provider the routine screening options available for prostate cancer. The discussion should take place at:

  • Age 50 for men of average risk
  • Age 45 for men at high risk, including African-American men and those with a first-degree relative (father or brother) who was diagnosed with prostate cancer before the age of 65
  • Age 40 for men at highest risk, including those with two or more first-degree relatives who had prostate cancer at an early age

Based on your discussion, your provider may screen you with a prostate specific antigen (PSA) test and possibly a digital rectal examination. Depending on the initial screening results and other risk factors, the screening may be repeated annually or once every two years.