In addition to regular physical examinations that may include blood, urine and possibly other laboratory tests, many groups, such as the American Cancer Society, suggest talking to your doctor to learn more about the pros and cons of screening for prostate cancer to help you decide if it is right for you. The tests commonly used in diagnosing prostate cancer include:
- DREs: Digital rectal examinations may be conducted annually for men over the age of 50. Men in high-risk groups, such as African-Americans, or those with a strong family history of prostate cancer should consult their physicians about being tested at age 45.
- PSA tests: Prostate-specific antigen tests may be done annually for men over the age of 50. Men in high-risk groups, such as African-Americans, or those with a strong family history of prostate cancer should consult their physicians about being tested at an earlier age.
Especially for men in their late 50s and 60s, the usefulness of the blood test may have to be decided on a case-by-case basis, according to new recommendations from the American Urological Association (AUA). The AUA recommends against the PSA test for men under age 40 or for those aged 40 to 54 at average risk for prostate cancer.
What are some other prostate cancer evaluation procedures?
If the DRE or PSA results are unusual, your physician may repeat the tests or request an ultrasound or other procedures. These additional evaluation tools may include:
- Prostate biopsy: A test where the doctor inserts thin, hollow needles into the prostate to get samples for examination under a microscope to determine if cancer cells are present.
- Transrectal ultrasound (TRUS): This is a test that uses sound wave echoes to create an image of the prostate gland to visually inspect for abnormal conditions such as gland enlargement, nodules, penetration of a tumor through capsule of the gland and/or invasion of seminal vesicles. It may also be used for guidance of needle biopsies of the prostate gland and/or guiding the nitrogen probes in cryosurgery.
- Computed tomography scan (CT scan): This is a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat and organs. CT scans are more detailed than general x-rays.
- Magnetic resonance imaging (MRI): This is a diagnostic procedure that uses a combination of large magnets, radiofrequencies and a computer to produce detailed images of organs and structures within the body.
- Radionuclide bone scan: This is a nuclear imaging method that helps to show whether the cancer has spread from the prostate gland to the bones. The procedure involves an injection of radioactive material that helps to locate diseased bone cells throughout the entire body, suggesting possible metastatic cancer.
- Lymph node biopsy: This is a procedure in which tissue samples are removed (with a needle or during surgery) from the lymph nodes for examination under a microscope to determine if cancer or other abnormal cells are present.
The diagnosis of cancer can be confirmed only by a biopsy.