Understanding Prostate Cancer: The Diagnosis
Your doctor can check for prostate cancer before you have any symptoms. During an office visit, your doctor will ask about your personal and family medical history. You'll have a physical exam. You may also have one or both of the following tests.
- Digital rectal exam: Your doctor inserts a lubricated, gloved finger into the rectum. This is a way to feel the prostate through the rectal wall. The prostate is checked for hard or lumpy areas.
- Blood test for prostate-specific antigens (PSA test): Your blood is tested for its level of PSA. Your prostate makes PSA. PSA can be elevated due to reasons other than cancer. These include benign hypertrophy (enlarged prostate), infection or inflammation.
These two common procedures are routine. They can show there is an issue. However, they cannot identify whether the problem is cancer or something else. Your doctor may perform other tests such as:
- Transrectal ultrasound: Your doctor inserts a probe into the rectum. This checks the prostate for abnormal areas. The probe sends out sound waves that people cannot hear. These are called ultrasounds. The waves bounce off the prostate. A computer uses the echoes to create a picture called a sonogram.
- Transrectal biopsy. This is the removal of tissue to look for cancer cells. It is the only sure way to diagnose prostate cancer. In this procedure, your doctor inserts needles through the rectum into the prostate. Then your doctor removes small tissue samples from many areas of the prostate. Usually a transrectal ultrasound is used to guide the insertion of the needles. Once the samples are removed, a pathologist will check the tissue samples under the microscope for abnormal cells.