Physicians will usually order a number of diagnostic tests before embarking on prostate cancer treatments. Some prefer to start with prostate cancer screening tests while others object to screening or question its value. Ideally, therefore, physicians will talk to their clients before ordering screening tests.

Prostate Cancer Screening Tests

The two major screening tests are digital rectal exam (DRE) and Prostate-Specific Antigen (PSA). Direct rectal examination involves insertion of a gloved, lubricated finger inside the rectum to assess abnormalities in size, shape and texture. The PSA test involves drawing venous blood for use in measuring PSA levels. Elevated PSA will indicate prostatic inflammation, cancer, infection or enlargement.

Confirmatory Prostate Cancer Diagnosis

Biopsy is the gold standard for diagnosing prostate cancer. The other fundamental diagnostic test is ultrasound imaging. In a biopsy, the physician or pathologist will take a tissue sample from the prostate using fine needle aspiration, prepare it for microscopic examination, and use the microscopic picture to arrive at a diagnosis. The trans-rectal ultrasound imaging method of diagnosing prostate cancer involves insertion of a small probe into the patient’s rectum and then reads the prostate’s anatomical picture through a special instrument.

Prostate Cancer Aggressiveness: Grading

After confirming a prostate cancer diagnosis, physicians proceed to determining the aggressiveness of the disease. This is called “cancer grading.” The pathologist will use the biopsy preparations to assess the differences between normal cancer cells and cancerous prostate cells. The greater the difference between the cancer cells and normal cells, the more aggressive the cancer. Grading is aided by the use of the Gleason scale which runs from 2 (non-aggressive) to 10 (highly aggressive).

Extent of Spread: Stage of Prostate Cancer

A diagnosis of prostate cancer is completed by determining the stage of the cancer. The physician will use bone scans, magnetic resonance imaging (MRI), ultrasound imaging, and computer tomography (CT) scan to stage the prostate cancer as stage I, II, III, or IV–with IV being the most advanced stage. For more information and assistance with prostate cancer diagnosis and treatment, visit the St Pete Urology website.