Prostate Cancer Diagnosis

Introduction: Prostate cancer affects millions worldwide. Through early prostate cancer diagnosis, the prognosis of this condition can improve drastically. With the help of various techniques such as PSA-testing, MRI, ultrasound and biopsy, prostate cancer can be detected early on and can be differentiated from other conditions.

If you or a loved one receive a prostate cancer diagnosis, the treating medical team will determine the stage and other qualities of the tumor. With these essential pieces of information they can develop an appropriate treatment plan.

In this article, we’ll guide you throughout the possible ways that prostate cancer can be diagnosed, as well as some frequently asked questions related to this topic.

How is prostate cancer diagnosed?

Prostate cancer can be diagnosed with the help of a number of diagnostic tools. Testing for prostate cancer will be done if there are any symptoms present that could point to prostate problems, especially if they go combined with risk factors such as advanced age, family history, obesity, and black ethnicity.

Tests for prostate cancer usually include:

• A prostate cancer test checking the level of prostate-specific antigen (PSA) in the blood. This technique is also referred to as PSA-testing.
• A digital rectal examination, which is done by examining the prostate with a gloved finger.

If the PSA-testing shows elevated PSA-levels, then the next step would be to undergo different tests for prostate cancer diagnosis.

An MRI can be used to look for prostatic abnormalities. This imaging technique uses a magnetic field to create a detailed picture of the prostate. A prostate ultrasound procedure is also possible. For this procedure, an ultrasound probe is inserted into the rectum to look for any abnormalities or enlargement of the prostate. If irregularities are detected, then a biopsy of the prostate can be performed to come to a prostate cancer diagnosis. Further testing may be necessary if there is a high chance that the cancer has spread to other parts of the body.

Can prostate cancer be detected through a blood test?

A blood test can be used to help detect prostate cancer. This blood test is called the PSA test and checks the level of prostate-specific antigen that is present in the blood. This test is however not accurate enough to diagnose prostate cancer on its own.

An elevated level of PSA can also point to other non-malignant changes to the prostate. For this reason, a positive PSA-test is followed by additional diagnostic tests such as a biopsy to confirm a diagnosis.

What does a high PSA level indicate?

A high PSA level may indicate prostate cancer, but can also be a sign of other benign conditions, such as:

• An enlarged prostate (without cancer cells, a so called benign prostate hyperplasia)
• An inflammation of the prostate, called prostatitis
• A urinary tract infection

The normal range for PSA varies with age and is different for men with different ethnicities. In general, the level of PSA is considered to be elevated and in need of further investigation in the following cases:

• Males 40-49 years: more than 2.5 ng/mL
• Males 50-59 years: more than 3.5 ng/mL
• Males 60-69 years: more than 4.5 ng/mL
• Males 70-79 years: more than 6.5 ng/mL

What is a prostate biopsy?

During a prostate biopsy, a sample from the prostate is collected so that it can be investigated thoroughly. It is the only method to safely confirm a prostate cancer diagnosis. A prostate biopsy is always performed in hospital and is usually an ambulatory procedure.