Prostate Cancer

How is prostate cancer diagnosed?

Several different tests can be used to diagnose prostate cancer, including:

• Digital rectal examination

  • Often part of a routine physical examination, during a digital rectal examination the doctor inserts a lubricated gloved finger into the rectum to examine the prostate which is located next to the rectum. This may be uncomfortable but should not be painful. If any abnormalities are found, you may be referred for further tests.
    
    

• Prostate-specific antigen (PSA) blood test

  • The Prostate-Specific Antigen (PSA) is a substance produced by the prostate and a small amount of it is normal, however men with prostate cancer tend to have higher levels of PSA in their blood. If higher than usual levels of PSA are found in a blood test that measures PSA levels, additional tests will be needed.
    
    

• Transrectal Ultrasound Scan (TRUS)

  • This test uses high-frequency sound waves to produce images of the prostate. It is done by inserting a small probe into the rectum which is located next to the prostate. TRUS is often recommended if a man has an abnormal digital rectum exam, or a high level of prostate-specific antigen (PSA) is found during the blood test. It is also commonly used during a prostate biopsy for the doctor to determine where to extract the sample tissue from.
    
    

• Biopsy

• During a prostate biopsy, small samples of prostate tissue are taken for further examination in the lab to determine the presence of cancer cells. Prostate biopsy samples can be collected by inserting a thin needle either through the rectum (transrectal biopsy) or through the area between the anus and scrotum (transperineal biopsy).
  

What tests are used to determine the spread of prostate cancer?

• Computer tomography (CT) scan

  • A CT scan takes X-ray images from different angles to build a 3D picture. This can identify the area where the cancer occurs in the prostate and show any spread to nearby structures or body parts.
    
    

• Magnetic Resonance Imaging (MRI) scan

  • An MRI scan uses magnetic fields to give detailed pictures of the pelvic area to detect prostate cancer and look for any spread to the lymph nodes.
    
    

• Bone scan
  

  • A bone scan can detect if the cancer has spread from the prostate to the bones. A small amount of radioactive material called a tracer is injected and a scan is done to see how the tracer is absorbed, to indicate the presence of cancer.
    
    

• Positron Emission Tomography - Computed Tomography (PET-CT) scan

• A PET-CT scan combines both a CT scan and a PET scan to provide more detailed 3D images that enable more accurate diagnosis. The scan uses X-rays to take images to check for any areas with abnormalities, while a radioactive glucose solution which is injected into the body and absorbed by cells that are growing quickly, can indicate the presence of cancer.