How is prostate cancer diagnosed. What tests are used to detect prostate cancer. What happens during a prostate biopsy. How accurate is PSA testing for prostate cancer. What are the stages of prostate cancer. How is prostate cancer graded.

Understanding Prostate Cancer Screening and Initial Detection

Prostate cancer often begins silently, with early stages rarely causing noticeable symptoms. This is why screening plays a crucial role in early detection. Most cases of prostate cancer are first identified through routine screening procedures rather than due to symptomatic presentations.

When prostate cancer is suspected based on screening results or symptoms, further diagnostic tests are necessary for confirmation. Primary care physicians typically refer patients to urologists, specialists who focus on cancers of the genital and urinary tract, including the prostate.

It’s important to note that while various tests can indicate the possibility of prostate cancer, a definitive diagnosis can only be made through a prostate biopsy.

Key Components of Initial Prostate Cancer Screening

• Digital Rectal Exam (DRE)
• Prostate-Specific Antigen (PSA) blood test
• Medical history assessment
• Evaluation of risk factors, including family history

The Role of Medical History and Physical Examination

When prostate cancer is suspected, a thorough medical history and physical examination are essential first steps. During this process, your doctor will inquire about any urinary or sexual symptoms you may be experiencing and their duration. They will also assess potential risk factors, with a particular focus on family history.

A critical component of the physical examination is the Digital Rectal Exam (DRE). During this procedure, the doctor inserts a gloved, lubricated finger into the rectum to feel for any abnormalities on the prostate, such as bumps or hard areas that might indicate cancer.

What Can a DRE Reveal?

A DRE can provide valuable information about the prostate’s condition:

• Presence of abnormal growths or hard areas
• Whether cancer is confined to one side of the prostate or both
• Potential spread of cancer to nearby tissues

While a DRE is an important diagnostic tool, it’s not definitive on its own. Additional tests are often ordered based on the findings of the medical history and physical examination.

Prostate-Specific Antigen (PSA) Blood Test: A Crucial Diagnostic Tool

The Prostate-Specific Antigen (PSA) blood test is a cornerstone in prostate cancer screening and diagnosis. PSA is a protein produced by both normal and cancerous prostate cells. While PSA is primarily found in semen, small amounts are also present in the blood, which is what this test measures.

Interpreting PSA Levels

PSA levels are measured in nanograms per milliliter (ng/mL) of blood. Generally, the risk of prostate cancer increases as PSA levels rise. However, there’s no universally agreed-upon cutoff point that definitively indicates the presence or absence of cancer.

• Most men without prostate cancer have PSA levels below 4 ng/mL
• PSA levels between 4 and 10 ng/mL (the “borderline range”) indicate about a 25% chance of prostate cancer
• PSA levels above 10 ng/mL suggest a greater than 50% chance of prostate cancer

It’s crucial to understand that these are general guidelines. Some men with PSA levels below 4 ng/mL may have prostate cancer, while many men with higher levels do not. This is why PSA testing is typically used in conjunction with other diagnostic tools.

PSA Testing in Diagnosed Prostate Cancer

For men already diagnosed with prostate cancer, PSA testing continues to play a vital role:

• Helps determine the cancer stage
• Guides treatment decisions
• Monitors treatment effectiveness
• Aids in detecting possible cancer recurrence after treatment

Prostate Biopsy: The Definitive Diagnostic Procedure

When PSA levels, DRE results, or other tests suggest the possibility of prostate cancer, a prostate biopsy is typically the next step. This procedure is the only way to definitively diagnose prostate cancer.

What Happens During a Prostate Biopsy?

A prostate biopsy involves taking small samples of prostate tissue for microscopic examination. The most common method is a core needle biopsy, usually performed by a urologist. The procedure typically follows these steps:

1. The prostate is visualized using imaging technology such as transrectal ultrasound (TRUS), MRI, or a fusion of both.
2. A thin, hollow needle is quickly inserted into the prostate.
3. Multiple tissue samples are collected from different areas of the prostate.
4. The samples are sent to a laboratory for analysis by a pathologist.

There are two main approaches to performing a prostate biopsy:

• Transrectal biopsy: The needle is inserted through the wall of the rectum.
• Transperineal biopsy: The needle is inserted through the skin between the scrotum and anus.

Advanced Imaging Techniques in Prostate Cancer Diagnosis

Modern prostate cancer diagnosis often incorporates advanced imaging techniques to improve accuracy and guide treatment decisions. These imaging methods can provide detailed information about the prostate’s structure and any suspicious areas.

Transrectal Ultrasound (TRUS)

TRUS uses sound waves to create images of the prostate. It’s often used to guide needle placement during a biopsy and can help identify some areas in the prostate that may be cancerous. However, it can’t definitively diagnose prostate cancer on its own.

Magnetic Resonance Imaging (MRI)

MRI provides detailed images of soft tissues like the prostate. It can help identify suspicious areas that may require biopsy and assist in determining if cancer has spread beyond the prostate. Multiparametric MRI (mpMRI) is a specialized type of MRI that’s particularly useful in prostate cancer diagnosis and staging.

MRI/Ultrasound Fusion Biopsy

This advanced technique combines the detailed imaging of MRI with real-time ultrasound guidance during biopsy. It allows for more precise targeting of suspicious areas, potentially improving the accuracy of prostate cancer diagnosis.

Grading and Staging Prostate Cancer

Once prostate cancer is diagnosed, determining its grade and stage is crucial for treatment planning and prognosis estimation.

Gleason Score and Grade Groups

The Gleason score is a grading system used to evaluate the aggressiveness of prostate cancer. It’s based on how the cancer cells look under a microscope. The score ranges from 2 to 10, with higher numbers indicating more aggressive cancer.

More recently, Grade Groups have been introduced to simplify the Gleason system:

• Grade Group 1 (Gleason 6 or less): Least aggressive
• Grade Group 2 (Gleason 3+4=7)
• Grade Group 3 (Gleason 4+3=7)
• Grade Group 4 (Gleason 8)
• Grade Group 5 (Gleason 9-10): Most aggressive

Staging Prostate Cancer

Staging describes how far the cancer has spread. The TNM system is commonly used:

• T (Tumor): Describes the size and extent of the main tumor
• N (Nodes): Indicates whether cancer has spread to nearby lymph nodes
• M (Metastasis): Shows whether cancer has spread to other parts of the body

Accurate staging may require additional tests such as bone scans, CT scans, or PET scans, depending on the initial findings.

Beyond Initial Diagnosis: Monitoring and Follow-up

Prostate cancer diagnosis doesn’t end with the initial tests. Ongoing monitoring is crucial, especially for men who choose active surveillance or have undergone treatment.

Active Surveillance

For men with low-risk prostate cancer, active surveillance may be an option. This involves regular monitoring through:

• Periodic PSA tests
• DRE examinations
• Repeat biopsies
• Potentially, periodic MRI scans

Post-Treatment Monitoring

After treatment, regular follow-up is essential to detect any signs of cancer recurrence. This typically involves:

• Regular PSA tests
• Physical examinations
• Imaging studies as needed

The frequency and type of follow-up tests depend on the initial cancer stage, treatment type, and individual risk factors.

Emerging Diagnostic Technologies in Prostate Cancer

The field of prostate cancer diagnosis is continuously evolving, with new technologies and approaches being developed to improve accuracy and reduce unnecessary biopsies.

Biomarker Tests

Several new blood and urine tests are being studied to complement PSA testing. These include:

• Prostate Health Index (PHI)
• 4Kscore Test
• ExoDx Prostate Test
• PCA3 Test

These tests aim to provide more specific information about cancer risk, potentially reducing the need for unnecessary biopsies.

Genetic Testing

Genetic tests are becoming increasingly important in prostate cancer diagnosis and management. They can help identify inherited cancer risk and guide treatment decisions. Some key genetic tests include:

• BRCA1 and BRCA2 mutation testing
• Mismatch repair (MMR) gene testing
• Genomic testing of tumor tissue

Artificial Intelligence in Imaging

Artificial intelligence (AI) and machine learning are being incorporated into prostate cancer imaging analysis. These technologies have the potential to:

• Improve the accuracy of MRI interpretation
• Assist in identifying suspicious areas for biopsy
• Help predict cancer aggressiveness

While these technologies show promise, they are still being refined and validated in clinical settings.

Patient-Centered Approach to Prostate Cancer Diagnosis

The journey through prostate cancer diagnosis can be complex and emotionally challenging. A patient-centered approach is crucial to ensure that individuals receive appropriate care aligned with their values and preferences.

Shared Decision Making

Shared decision making is a collaborative process between patients and healthcare providers. It involves:

• Discussing the benefits and risks of different diagnostic approaches
• Considering the patient’s personal values and preferences
• Making informed decisions about screening, further testing, and treatment options

Managing Anxiety and Uncertainty

The diagnostic process can be a source of significant anxiety for many men. Healthcare providers should address this by:

• Providing clear, understandable information about test results and their implications
• Offering access to counseling or support services
• Discussing coping strategies for dealing with uncertainty

Multidisciplinary Care

A multidisciplinary approach to prostate cancer diagnosis and care can provide comprehensive support. This team might include:

• Urologists
• Medical oncologists
• Radiation oncologists
• Pathologists
• Radiologists
• Nurse specialists
• Mental health professionals

This collaborative approach ensures that patients receive well-rounded care addressing all aspects of their diagnosis and subsequent treatment.

The Future of Prostate Cancer Diagnosis

As research continues, the landscape of prostate cancer diagnosis is likely to evolve. Future developments may include:

• More precise biomarkers for early detection and risk stratification
• Advanced imaging techniques that could potentially replace or reduce the need for invasive biopsies
• Personalized screening protocols based on individual risk factors and genetic profiles
• Integration of artificial intelligence in diagnostic processes for improved accuracy and efficiency

These advancements aim to improve the accuracy of prostate cancer diagnosis while minimizing unnecessary procedures and reducing the risk of overdiagnosis and overtreatment.

In conclusion, prostate cancer diagnosis is a multifaceted process that combines various tests, imaging techniques, and clinical assessments. While current methods have significantly improved our ability to detect and characterize prostate cancer, ongoing research promises even more precise and personalized diagnostic approaches in the future. As always, men should discuss their individual risk factors and screening options with their healthcare providers to make informed decisions about prostate cancer detection and management.

Tests for Prostate Cancer | Prostate Cancer Diagnosis

Most prostate cancers are first found as a result of screening.
(See Screening Tests for Prostate Cancer.) Early prostate cancers usually don’t cause symptoms, but more advanced cancers are sometimes first found because of symptoms they cause.

If prostate cancer is suspected based on results of screening tests or symptoms, tests will be needed to be sure. If you’re seeing your primary care doctor, you might be referred to a urologist, a doctor who treats cancers of the genital and urinary tract, including the prostate.

The actual diagnosis of prostate cancer can only be made with a prostate biopsy (discussed below).

Medical history and physical exam

If your doctor suspects you might have prostate cancer, he or she will ask you about any symptoms you are having, such as any urinary or sexual problems, and how long you have had them. You might also be asked about possible risk factors, including your family history.

Your doctor will also examine you. This might include a digital rectal exam (DRE), during which the doctor inserts a gloved, lubricated finger into your rectum to feel for any bumps or hard areas on the prostate that might be cancer. If you do have cancer, the DRE can sometimes help tell if it’s only on one side of the prostate, if it’s on both sides, or if it’s likely to have spread beyond the prostate to nearby tissues. Your doctor may also examine other areas of your body.

After the exam, your doctor might then order some tests.

PSA blood test

Prostate-specific antigen (PSA) is a protein made by cells in the prostate gland (both normal cells and cancer cells). PSA is mostly in semen, but a small amount is also in the blood. 

Use in men who might have prostate cancer

The PSA blood test is used mainly to screen for prostate cancer in men without symptoms. It’s also one of the first tests done in men who have symptoms that might be caused by prostate cancer.

PSA in the blood is measured in units called nanograms per milliliter (ng/mL). The chance of having prostate cancer goes up as the PSA level goes up, but there is no set cutoff point that can tell for sure if a man does or doesn’t have prostate cancer. Many doctors use a PSA cutoff point of 4 ng/mL or higher when deciding if a man might need further testing, while others might recommend it starting at a lower level, such as 2.5 or 3. 

• Most men without prostate cancer have PSA levels under 4 ng/mL of blood. Still, a level below 4 is not a guarantee that a man doesn’t have cancer.
• Men with a PSA level between 4 and 10 (often called the “borderline range”) have about a 1 in 4 chance of having prostate cancer. 
• If the PSA is more than 10, the chance of having prostate cancer is over 50%.
  

If your PSA level is high, you might need further tests to look for prostate cancer. 

To learn more about how the PSA test is used to look for cancer, including factors that can affect PSA levels, special types of PSA tests, and what the next steps might be if you have an abnormal PSA level, see Screening Tests for Prostate Cancer.

Use in men already diagnosed with prostate cancer

The PSA test can also be useful if you have already been diagnosed with prostate cancer.

• In men just diagnosed with prostate cancer, the PSA level can be used together with physical exam results and tumor grade (determined on the biopsy, described further on) to help decide if other tests (such as CT scans or bone scans) are needed.
• The PSA level is used to help determine the stage of your cancer. This can affect your treatment options, since some treatments (such as surgery and radiation) are not likely to be helpful if the cancer has spread to other parts of the body.
• PSA tests are often an important part of determining how well treatment is working, as well as in watching for a possible recurrence of the cancer after treatment (see Following PSA Levels During and After Treatment).

Prostate biopsy

If the results of a PSA blood test, DRE, or other tests suggest that you might have prostate cancer, you will most likely need a prostate biopsy.

A biopsy is a procedure in which small samples of the prostate are removed and then looked at with a microscope. A core needle biopsy is the main method used to diagnose prostate cancer. It is usually done by a urologist.

During the biopsy, the doctor usually looks at the prostate with an imaging test such as transrectal ultrasound (TRUS) or MRI, or a ‘fusion’ of the two (all discussed below). The doctor quickly inserts a thin, hollow needle into the prostate. This is done either through the wall of the rectum (a transrectal biopsy) or through the skin between the scrotum and anus (a transperineal biopsy). When the needle is pulled out it removes a small cylinder (core) of prostate tissue. This is repeated several times. Most often the doctor will take about 12 core samples from different parts of the prostate.

Though the procedure sounds painful, each biopsy usually causes only some brief discomfort because it is done with a special spring-loaded biopsy instrument. The device inserts and removes the needle in a fraction of a second. Most doctors who do the biopsy will numb the area first by injecting a local anesthetic alongside the prostate. You might want to ask your doctor if he or she plans to do this.

The biopsy itself takes about 10 minutes and is usually done in the doctor’s office. You will likely be given antibiotics to take before the biopsy and possibly for a day or 2 after to reduce the risk of infection.

For a few days after the procedure, you may feel some soreness in the area and might notice blood in your urine. You may also have some light bleeding from your rectum, especially if you have hemorrhoids. Many men notice blood in their semen or have rust colored semen, which can last for several weeks after the biopsy, depending on how often you ejaculate.

Getting the results of the biopsy

Your biopsy samples will be sent to a lab, where they will be looked at with a microscope to see if they contain cancer cells. Getting the results (in the form of a pathology report) usually takes at least 1 to 3 days, but it can sometimes take longer. The results might be reported as:

• Positive for cancer: Cancer cells were seen in the biopsy samples.
• Negative for cancer: No cancer cells were seen in the biopsy samples.
• Suspicious: Something abnormal was seen, but it might not be cancer. (Different types of suspicious results are discussed below.)

If the biopsy is negative

If the prostate biopsy results are negative (that is, if they don’t show cancer), and the chance that you have prostate cancer isn’t very high based on your PSA level and other tests, you might not need any more tests, other than repeat PSA tests (and possibly DREs) sometime later.

But even if many samples are taken, biopsies can still sometimes miss a cancer if none of the biopsy needles pass through it. This is known as a false-negative result. If your doctor still strongly suspects you have prostate cancer (because your PSA level is very high, for example), your doctor might suggest:

• Getting other lab tests (of blood, urine, or the prostate biopsy samples) to help get a better idea of whether or not you might have prostate cancer. Examples of such tests include the Prostate Health Index (PHI), 4Kscore test, PCA3 tests (such as Progensa), and ConfirmMDx. These tests are discussed in What’s New in Prostate Cancer Research?
• Getting a repeat prostate biopsy. This might include getting additional samples of parts of the prostate not biopsied the first time, or using imaging tests such as MRI (described below) to look more closely for abnormal areas to target.

Prostate cancer grade (Gleason score or Grade Group)

If prostate cancer is found on a biopsy, it will be assigned a grade. The grade of the cancer is based on how abnormal the cancer looks under the microscope. Higher grade cancers look more abnormal, and are more likely to grow and spread quickly. There are 2 main ways to describe the grade of a prostate cancer.

Gleason score

The Gleason system, which has been in use for many years, assigns grades based on how much the cancer looks like normal prostate tissue.

• If the cancer looks a lot like normal prostate tissue, a grade of 1 is assigned.
• If the cancer looks very abnormal, it is given a grade of 5.
• Grades 2 through 4 have features in between these extremes.

Almost all cancers are grade 3 or higher; grades 1 and 2 are not often used.

Since prostate cancers often have areas with different grades, a grade is assigned to the 2 areas that make up most of the cancer. These 2 grades are added to yield the Gleason score (also called the Gleason sum).

The first number assigned is the grade that is most common in the tumor. For example, if the Gleason score is written as 3+4=7, it means most of the tumor is grade 3 and less is grade 4, and they are added for a Gleason score of 7.

Although most often the Gleason score is based on the 2 areas that make up most of the cancer, there are some exceptions when a biopsy sample has either a lot of high-grade cancer or there are 3 grades including high-grade cancer. In these cases, the way the Gleason score is determined is modified to reflect the aggressive (fast-growing) nature of the cancer.

In theory, the Gleason score can be between 2 and 10, but scores below 6 are rarely used.

Based on the Gleason score, prostate cancers are often divided into 3 groups:

• Cancers with a Gleason score of 6 or less may be called well-differentiated or low-grade.
• Cancers with a Gleason score of 7 may be called moderately-differentiated or intermediate-grade.
• Cancers with Gleason scores of 8 to 10 may be called poorly-differentiated or high-grade.

Grade Groups

In recent years, doctors have come to realize that the Gleason score might not always be the best way to describe the grade of the cancer, for a couple of reasons:

• Prostate cancer outcomes can be divided into more than just the 3 groups mentioned above. For example, men with a Gleason score 3+4=7 cancer tend to do better than those with a 4+3=7 cancer. And men with a Gleason score 8 cancer tend to do better than those with a Gleason score of 9 or 10.
• The scale of the Gleason score can be misleading for patients. For example, a man with a Gleason score 6 cancer might assume that his cancer is in the middle of the range of grades (which in theory go from 2 to 10), even though grade 6 cancers are actually the lowest grade seen in practice. This assumption might lead a man to think his cancer is more likely to grow and spread quickly than it really is, which might affect his decisions about treatment.

Because of this, doctors have developed Grade Groups, ranging from 1 (most likely to grow and spread slowly) to 5 (most likely to grow and spread quickly):

• Grade Group 1 = Gleason 6 (or less)
• Grade Group 2 = Gleason 3+4=7
• Grade Group 3 = Gleason 4+3=7
• Grade Group 4 = Gleason 8
• Grade Group 5 = Gleason 9-10

The Grade Groups will likely replace the Gleason score over time, but currently you might see either one (or both) on a biopsy pathology report.

Other information in a pathology report

Along with the grade of the cancer (if it is present), the pathology report often contains other information about the cancer, such as:

• The number of biopsy core samples that contain cancer (for example, “7 out of 12”)
• The percentage of cancer in each of the cores
• Whether the cancer is on one side (left or right) of the prostate or on both sides (bilateral)

Suspicious results

Sometimes when the prostate cells are seen, they don’t look like cancer, but they’re not quite normal, either.

Prostatic intraepithelial neoplasia (PIN): In PIN, there are changes in how the prostate cells look, but the abnormal cells don’t look like they’ve grown into other parts of the prostate (like cancer cells would). PIN is often divided into 2 groups:

• Low-grade PIN: The patterns of prostate cells appear almost normal.
• High-grade PIN: The patterns of cells look more abnormal.

Many men begin to develop low-grade PIN at an early age, but low-grade PIN is not thought to be related to prostate cancer risk. If low-grade PIN is reported on a prostate biopsy, the follow-up for patients is usually the same as if nothing abnormal was seen.

If high-grade PIN is found on a biopsy, there is a greater chance that you might develop prostate cancer over time. This is why doctors often watch men with high-grade PIN carefully and may advise another prostate biopsy (or lab tests to help determine the risk of having cancer, such as the Prostate Health Index (PHI), 4Kscore test, PCA3 tests (such as Progensa), or ConfirmMDx). This is especially true if high-grade PIN is found in different parts of the prostate (multifocal high-grade PIN), or if the original biopsy did not take samples from all parts of the prostate.

Atypical small acinar proliferation (ASAP): This might also be called glandular atypia or atypical glandular proliferation. It might also just be reported as “suspicious for cancer.” All of these terms mean that the cells look like they might be cancer when seen with the microscope, but there are too few of them to be sure. If one of these terms is used, there’s a high chance that there is also cancer in the prostate, which is why many doctors recommend repeating the biopsy within a few months.

Proliferative inflammatory atrophy (PIA): In PIA, the prostate cells look smaller than normal, and there are signs of inflammation in the area. PIA is not cancer, but researchers believe that PIA may sometimes lead to high-grade PIN or to prostate cancer directly.

For more information about how prostate biopsy results are reported, see the Prostate Pathology section of our website.

Genetic testing for some men with prostate cancer

Some doctors
now recommend that some men with prostate cancer be tested to look for certain inherited gene changes. This includes men in whom a family cancer syndrome (such as a BRCA gene mutation or Lynch syndrome) is suspected, as well as men with prostate cancer that has certain high-risk features or that has spread to other parts of the body. Talk to your doctor about the possible pros, cons, and limitations of such testing. 

Imaging tests for prostate cancer

Imaging tests use x-rays, magnetic fields, sound waves, or radioactive substances to create pictures of the inside of your body. One or more imaging tests might be used:

• To look for cancer in the prostate
• To help the doctor see the prostate during certain procedures (such as a prostate biopsy or certain types of prostate cancer treatment)
• To look for spread of prostate cancer to other parts of the body

Which tests you might need will depend on the situation. For example, a prostate biopsy is typically done with transrectal ultrasound (TRUS) and/or MRI to help guide the biopsy. If you are found to have prostate cancer, you might need imaging tests of other parts of your body to look for possible cancer spread. (Men with a normal DRE result, a low PSA, and a low Gleason score may not need any other tests because the chance that the cancer has spread is so low.)

The imaging tests used most often to look for prostate cancer spread include:

Transrectal ultrasound (TRUS)

For this test, a small probe about the width of a finger is lubricated and placed in your rectum. The probe gives off sound waves that enter the prostate and create echoes. The probe picks up the echoes, and a computer turns them into a black and white image of the prostate.

The procedure often takes less than 10 minutes and is done in a doctor’s office or outpatient clinic. You will feel some pressure when the probe is inserted, but it is usually not painful. The area may be numbed before the procedure.

TRUS might be used in different situations: 

• It is sometimes used to look for suspicious areas in the prostate in men who have an abnormal DRE or PSA test result (although it can miss some cancers). 
• It can be used during a prostate biopsy to guide the needles into the correct area of the prostate.
• It can be used to measure the size of the prostate gland, which can help determine the PSA density (described in Screening Tests for Prostate Cancer). 
• It can be used as a guide during some forms of treatment such as brachytherapy (internal radiation therapy) or cryotherapy.

Newer forms of TRUS, such as color Doppler ultrasound, might be even more helpful in some situations. (See What’s New in Prostate Cancer Research?)

Magnetic resonance imaging (MRI)

MRI scans create detailed images of soft tissues in the body using radio waves and strong magnets. MRI scans can give doctors a very clear picture of the prostate and nearby areas. A contrast material called gadolinium may be injected into a vein before the scan to better see details.

MRI might be used in different situations:

• It can be used to help determine if a man with an abnormal screening test or with symptoms that might be from prostate cancer should get a prostate biopsy. (The type of MRI often used for this, known as multiparametric MRI, is described below.)
• If a prostate biopsy is planned, an MRI might be done to help locate and target areas of the prostate that are most likely to contain cancer. This is often done as an MRI/ultrasound fusion biopsy, which is described below.
• MRI can be used during a prostate biopsy to help guide the needles into the prostate.
• If prostate cancer has been found, MRI can be done to help determine the extent (stage) of the cancer. MRI scans can show if the cancer has spread outside the prostate into the seminal vesicles or other nearby structures. This can be very important in determining your treatment options. But MRI scans aren’t usually needed for newly diagnosed prostate cancers that are likely to be confined to the prostate based on other factors.

To improve the accuracy of the MRI, you might have a probe, called an endorectal coil, placed inside your rectum for the scan. This can be uncomfortable for some men. If needed, you can be given medicine to make you feel sleepy (sedation).

Multiparametric MRI: This newer MRI technique can be used to help better define possible areas of cancer in the prostate, as well as to get an idea of how quickly a cancer might grow. It can also help show if the cancer has grown outside the prostate or spread to other parts of the body. For this test, a standard MRI is done to look at the anatomy of the prostate, and then at least one other type of MRI (such as diffusion weighted imaging [DWI], dynamic contrast enhanced [DCE] MRI, or MR spectroscopy) is done to look at other parameters of the prostate tissue. The results of the different scans are then compared to help find abnormal areas.

When this test is done to help determine if a man might have prostate cancer, the results are typically reported using the Prostate Imaging Reporting and Data System, or PI-RADS. In this system, abnormal areas in the prostate are assigned a category on a scale ranging from PI-RADS 1 (very unlikely to be a clinically significant cancer) to PI-RADS 5 (very likely to be a clinically significant cancer).

MRI/ultrasound fusion-guided prostate biopsy: In this approach, a man gets an MRI scan a few days or weeks before the biopsy to look for abnormal areas in the prostate. During the biopsy itself, TRUS is used to view to prostate, and a special computer program is used to fuse the MRI and TRUS images on a computer screen. This can help ensure the doctor gets biopsy samples from any suspicious areas seen on the images.

Bone scan

If prostate cancer spreads to distant parts of the body, it often goes to the bones first. A bone scan can help show if cancer has reached the bones.

For this test, you are injected with a small amount of low-level radioactive material, which settles in damaged areas of bone throughout the body. A special camera detects the radioactivity and creates a picture of your skeleton.

A bone scan might suggest cancer in the bone, but to make an accurate diagnosis, other tests such as plain x-rays, CT or MRI scans, or even a bone biopsy might be needed.

Positron emission tomography (PET) scan

A PET scan is similar to a bone scan, in that a slightly radioactive substance (known as a tracer) is injected into the blood, which can then be detected with a special camera. But PET scans use different tracers that collect mainly in cancer cells. The most common tracer for standard PET scans is FDG, which is a type of sugar. Unfortunately, this type of PET scan isn’t very useful in finding prostate cancer cells in the body.

However, newer tracers, such as fluciclovine F18, sodium fluoride F18, and choline C11, have been found to be better at detecting prostate cancer cells.

Other newer tracers, such as Ga 68 PSMA-11 and 18F-DCFPyl (also known as piflufolastat F 18 or Pylarify), attach to prostate-specific membrane antigen (PSMA), a protein that is often found in large amounts on prostate cancer cells. Tests using these types of tracers are sometimes referred to as PSMA PET scans.

These newer types of PET scans are most often used if it’s not clear if (or exactly where) prostate cancer has spread. For example, one of these tests might be done if the results of a bone scan aren’t clear, or if a man has a rising PSA level after initial treatment but it’s not clear where the cancer is in the body.

The pictures from a PET scan aren’t as detailed as MRI or CT scan images, but they can often show areas of cancer anywhere in the body. Some machines can do a PET scan and either an MRI (PET-MRI) or a CT scan (PET-CT) at the same time, which can give more detail about areas that show up on the PET scan. 

Doctors are still learning about the best ways to use these newer types of PET scans, and some of them might not be available yet in all imaging centers.

Computed tomography (CT) scan

A CT scan uses x-rays to make detailed, cross-sectional images of your body. This test isn’t often needed for newly diagnosed prostate cancer if the cancer is likely to be confined to the prostate based on other findings (DRE result, PSA level, and Gleason score). Still, it can sometimes help tell if prostate cancer has spread into nearby lymph nodes. If your prostate cancer has come back after treatment, the CT scan can often tell if it is growing into other organs or structures in your pelvis.

CT scans are not as useful as magnetic resonance imaging (MRI) for looking at the prostate gland itself.

Lymph node biopsy

In a lymph node biopsy, also known as lymph node dissection or lymphadenectomy, one or more lymph nodes are removed to see if they have cancer cells. This isn’t done very often for prostate cancer, but it might be used to find out if the cancer has spread from the prostate to nearby lymph nodes.

Biopsy during surgery to treat prostate cancer

If there is more than a very small chance
that the cancer might have spread (based on factors such as a high PSA level or a high Gleason score), the surgeon may remove lymph nodes in the pelvis during the same operation as the removal of the prostate, which is known as a radical prostatectomy (see Surgery for Prostate Cancer).

The lymph nodes and the prostate are then sent to the lab to be looked at. The lab results are usually available several days after surgery.

Lymph node biopsy as a separate procedure

A lymph node biopsy is rarely done as a separate procedure. It’s sometimes used when a radical prostatectomy isn’t planned (such as for some men who choose treatment with radiation therapy), but when it’s still important to know if the lymph nodes contain cancer.

Most often, this is done as a needle biopsy. To do this, the doctor uses an image (such as from an MRI or CT scan) to guide a long, hollow needle through the skin in the lower abdomen and into an enlarged node. The skin is numbed with local anesthesia before the needle is inserted to take a small tissue sample. The sample is then sent to the lab and looked at for cancer cells.

What Is Screening for Prostate Cancer?

Some men get a PSA test to screen for prostate cancer. Talk to your doctor, learn what is involved, and decide if a PSA test is right for you.

Cancer screeningexternal icon means looking for cancer before it causes symptoms. The goal of screening for prostate cancer is to find cancers that may be at high risk for spreading if not treated, and to find them early before they spread.

If you are thinking about being screened, learn about the possible benefits and harms of screening, diagnosis, and treatment, and talk to your doctor about your personal risk factors.

There is no standard test to screen for prostate cancer. Two tests that are commonly used to screen for prostate cancer are described below.

Prostate Specific Antigen (PSA) Test

A blood test called a prostate specific antigen (PSA) test measures the level of PSA in the blood. PSA is a substance made by the prostate. The levels of PSA in the blood can be higher in men who have prostate cancer. The PSA level may also be elevated in other conditions that affect the prostate.

As a rule, the higher the PSA level in the blood, the more likely a prostate problem is present. But many factors, such as age and race, can affect PSA levels. Some prostate glands make more PSA than others.

PSA levels also can be affected by—

• Certain medical procedures.
• Certain medications.
• An enlarged prostate.
• A prostate infection.

Because many factors can affect PSA levels, your doctor is the best person to interpret your PSA test results. If the PSA test is abnormal, your doctor may recommend a biopsy to find out if you have prostate cancer.

Digital Rectal Examination (DRE)

Digital rectal examination (DRE) is when a health care provider inserts a gloved, lubricated finger into a man’s rectum to feel the prostate for anything abnormal, such as cancer. The U.S. Preventive Services Task Forceexternal icon does not recommend DRE as a screening test because of lack evidence on the benefits.

5 Things Men Should Know About A Prostate Exam

According to the American Cancer Society, an estimated one in nine men will be diagnosed with prostate cancer. Though it is the second leading cause of cancer death among American men, preventative screenings like a prostate exam can help catch the disease before it becomes fatal.

Matthew Sand, M.D., a urologist at Piedmont, answers five questions men commonly ask about prostate exams.

1.What is a prostate exam?

“A prostate exam is a digital or finger exam in the rectum to feel the prostate through the rectal wall,” says Dr. Sand. “We estimate the size of the prostate and then we feel around for nodules, which are concerning for prostate cancer.”

Prostate exams can be performed along with a prostate-specific antigen (PSA) blood test, which measures the amount of PSA made by the prostate gland. The higher the PSA level, the higher the likelihood that there is a problem with the prostate gland.

“Occasionally you’ll have prostate cancers that don’t make a high PSA,” says Dr. Sand. “But when we perform the rectal exam, we can detect if there is a lump or a nodule in the prostate. So, it’s very important to do the PSA blood test in combination with the rectal exam.”

2. Who should get a prostate exam?

Men over the age of 50 should have an annual prostate exam, says Dr. Sand. If you have a family history of the disease, the exam can be performed as early as age 40.

3. What happens during the prostate exam?

“The exam is fairly straightforward,” says Dr. Sand. “Patients bend over the exam table positioning their elbows on the table. Wearing a lubricated glove, the doctor inserts his index finger into the rectum. We then palpitate the prostate from side-to-side a couple of times, taking a feel for nodules, bumps, lumps or a hard spot. Then we estimate the size of the prostate gland. ”

4. Does a prostate exam hurt?

“The whole procedure probably takes three to five seconds,” says Dr. Sand. “A little short-term discomfort can save you a lot of long-term pain and suffering.”

5. Why is it important to get a prostate screening?

Men aren’t great healthcare-seekers on their own, says Dr. Sand.

“They usually go to the doctor for lifestyle issues like erectile dysfunction or urinary issues, but often delay screening testing,” he says.

Prostate cancer is asymptomatic, which means men usually don’t show signs or symptoms of the disease until it’s in a more advanced stage.

“A screening is the only way to catch prostate cancer in the early stages,” says Dr. Sand. “If caught early, it’s very treatable and the survival rate is excellent. If you don’t screen and take care of it, the outcomes are much worse.”

Find a urologist near you so you can schedule a prostate cancer screening. The exam only takes a few minutes and it could save your life.

Need to make an appointment with a Piedmont physician? Save time, book online.

Prostate Cancer: Screening | Cancer.Net

ON THIS PAGE: You will find out more about screening for prostate cancer. You will also learn the risks and benefits of screening. Use the menu to see other pages.

Screening is used to look for cancer before you have any symptoms or signs. When cancer is found earlier in its development, it is often at an earlier stage. This means that there is a better chance of successfully treating the cancer. Scientists have developed, and continue to develop, tests that can be used to screen a person for specific types of cancer. The overall goals of cancer screening are to:

• Lower the number of people who die from the disease, or eliminate deaths from cancer altogether

• Lower the number of people who develop the disease

Learn more about the basics of cancer screening.

Screening information for prostate cancer

Screening for prostate cancer is done to find evidence of cancer in otherwise healthy adults. Two tests are commonly used to screen for prostate cancer:

• Digital rectal examination (DRE). A DRE is a test in which the doctor inserts a gloved, lubricated finger into the rectum and feels the surface of the prostate through the bowel wall for any irregularities.

• PSA blood test. There is controversy about using the PSA test to look for prostate cancer in people with no symptoms of the disease. On the one hand, the PSA test is useful for detecting early-stage prostate cancer, especially in those with many risk factors, which helps some get the treatment they need before the cancer grows and spreads. On the other hand, PSA screening may find very-slow-growing prostate cancers that would never threaten someone’s life. As a result, screening for prostate cancer using PSA may lead to treatments that are not needed, which can cause side effects and seriously affect a person’s quality of life.

ASCO recommends that people with no symptoms of prostate cancer and who are expected to live less than 10 years do not receive PSA screening. For those expected to live longer than 10 years, ASCO recommends that they talk with their doctor to find out if the test is appropriate for them.

Other organizations have different recommendations for screening:

• The U.S. Preventive Services Task Force (USPSTF) recommends that adults between 55 and 69 should discuss the pros and cons of PSA screening with their doctor before making a decision about screening. People who are 70 and older should not have routine PSA screenings for prostate cancer.

• Both the American Urological Association and the American Cancer Society recommend that people be told the risks and benefits of testing before PSA screening occurs and then make an informed decision in consultation with their doctor.

• The National Comprehensive Cancer Network (NCCN) considers a patient’s age, PSA value, DRE results, and other factors in their recommendations.

It is not easy to predict which tumors will grow and spread quickly and which will grow slowly. Everyone should discuss with their doctor the pros and cons of prostate cancer screening based on their situation and personal risk of prostate cancer, so they can work together to make an informed decision.

The next section in this guide is Symptoms and Signs. It explains what body changes or medical problems prostate cancer can cause. Use the menu to choose a different section to read in this guide.

Prostate Cancer: Age-Specific Screening Guidelines

Prostate Cancer Screening Ages 40 to 54

The PSA test is a blood test that measures how much of a particular protein
(called prostate-specific antigen) is in your blood. It’s been the standard
for prostate cancer screening for 30 years.

Your doctor will consider many factors before suggesting when to start
prostate cancer screening. But he’ll probably start by recommending the PSA
test.

While the general guidelines recommend starting at age 55, you may need PSA
screening between the ages of 40 and 54 if you:

• Have at least one first-degree relative (such as your father or
  brother) who has had prostate cancer
• Have at least two extended family members who have had prostate cancer
• Are African-American, an ethnicity that has a higher risk of developing
  more aggressive cancers

Prostate Cancer Screening Ages 55 to 69

This is the age range where men will benefit the most from screening.
That’s because this is the time when:

• Men are most likely to get cancer
• Treatment makes the most sense, meaning when treatment benefits
  outweigh any potential risk of treatment side effects

Most men will get prostate cancer if they live long enough. Some prostate
cancers are more aggressive; others can be slow-growing. Doctors will take
your age and other factors into consideration before weighing the risks and
benefits of treatment.

You should ask your doctor how often he or she recommends you get screened.
For most men, every two to three years is enough.

Depending on the results of your first PSA test, your doctor may recommend
you get screened less (or more) frequently.

Decoding a PSA Test

Doctors will consider your age and the size of your prostate when
determining what your PSA score means. In general:

• For men in their 40s and 50s: A PSA score greater than 2.5 ng/ml is
  considered abnormal. The median PSA for this age range is 0.6 to 0.7
  ng/ml.
• For men in their 60s: A PSA score greater than 4.0 ng/ml is considered
  abnormal. The normal range is between 1.0 and 1.5 ng/ml.
• An abnormal rise: A PSA score may also be considered abnormal if it
  rises a certain amount in a single year. For example, if your score
  rises more than 0.35 ng/ml in a single year, your doctor may recommend
  further testing.

An Abnormal PSA Test: What Comes Next?

If your PSA score is in the abnormal range, your doctor may recommend you
repeat the PSA test. If your levels are still high, your doctor might
recommend one of the newer prostate cancer screening tests available today.

These tests can help better assess your risk for prostate cancer and
determine whether a biopsy is necessary. Only a prostate biopsy can
definitively diagnose prostate cancer.

For individualized recommendations that suit you, ask your doctor about:

• What age you should start prostate cancer screening
• New blood, urine and imaging tests that are available
• Improved biopsy techniques, if applicable

Prostate Tests | NIDDK

On this page:

What is the prostate?

The prostate is a walnut-shaped gland that is part of the male reproductive system. It has two or more lobes, or sections, enclosed by an outer layer of tissue. The prostate is located in front of the rectum and just below the bladder, where urine is stored. It surrounds the urethra at the neck of the bladder and supplies fluid that goes into semen.

Side view of male urinary tract

What are some common prostate problems?

The most common prostate problem in men younger than age 50 is inflammation, called prostatitis. Prostate enlargement, or benign prostatic hyperplasia (BPH), is another common problem. Because the prostate continues to grow as a man ages, BPH is the most common prostate problem for men older than age 50. Older men are at risk for prostate cancer as well, but it is much less common than BPH.

What are the symptoms of prostate problems?

The symptoms of prostate problems may include

• urinary retention—the inability to empty the bladder completely
• urinary frequency—urination eight or more times a day
• urinary urgency—the inability to delay urination
• urinary incontinence—the accidental loss of urine
• nocturia—frequent urination at night
• trouble beginning a urine stream
• weak or interrupted urine stream
• blockage of urine
• urine that has an unusual color or odor
• pain after ejaculation or during urination

Different prostate problems may have similar symptoms. For example, one man with prostatitis and another with BPH may both experience urinary urgency. Sometimes symptoms for the same prostate problem differ among individuals. For example, one man with BPH may have trouble beginning a urine stream, while another may experience nocturia. A man in the early stages of prostate cancer may have no symptoms at all. Because of this confusing array of symptoms, a thorough medical exam and testing are vital.

How are prostate problems diagnosed?

To diagnose prostate problems, the health care provider will perform a digital rectal exam (DRE). The health care provider will also ask the patient

• when the problem began and how often it occurs
• what symptoms are present
• whether he has a history of recurrent urinary tract infections
• what medications he takes, both prescription and those bought over the counter
• the amount of fluid he typically drinks each day
• whether he consumes caffeine and alcohol
• about his general medical history, including any major illnesses or surgeries

Answers to these questions will help the health care provider identify the problem or determine what medical tests are needed. Diagnosing BPH may require a series of medical exams and tests.

How is a digital rectal exam (DRE) performed?

A DRE is a physical exam of the prostate. The health care provider will ask the patient to bend over a table or lie on his side while holding his knees close to his chest. The health care provider slides a gloved, lubricated finger into the rectum and feels the part of the prostate that lies next to it. The DRE may be slightly uncomfortable, but it is brief. This exam reveals whether the prostate has any abnormalities that require more testing. If an infection is suspected, the health care provider might massage the prostate during the DRE to obtain fluid to examine with a microscope. This exam is usually done first. Many health care providers perform a DRE as part of a routine physical exam for men age 50 or older, some even at age 40, whether or not the man has urinary problems.

Digital rectal exam

What is the first test for detecting prostate problems?

The first test for detecting prostate problems is a blood test to measure prostate-specific antigen (PSA), a protein made only by the prostate gland. This test is often included in routine physical exams for men older than age 50. Because African American men have higher rates of getting, and dying from, prostate cancer than men of other racial or ethnic groups in the United States, medical organizations recommend a PSA blood test be given starting at age 40 for African American men. Medical organizations also recommend a PSA blood test be given starting at age 40 for men with a family history of prostate cancer. Some medical organizations even recommend a PSA blood test be given to all men starting at age 40.

If urination problems are present or if a PSA blood test indicates a problem, additional tests may be ordered. These tests may require a patient to change his diet or fluid intake or to stop taking medications. If the tests involve inserting instruments into the urethra or rectum, antibiotics may be given before and after the test to prevent infection.

Why is a prostate-specific antigen (PSA) blood test performed?

A PSA blood test is performed to detect or rule out prostate cancer. The amount of PSA in the blood is often higher in men who have prostate cancer. However, an elevated PSA level does not necessarily indicate prostate cancer. The U.S. Food and Drug Administration has approved the PSA blood test for use in conjunction with a DRE to help detect prostate cancer in men age 50 or older and for monitoring men with prostate cancer after treatment. However, much remains unknown about how to interpret a PSA blood test, its ability to discriminate between cancer and problems such as BPH and prostatitis, and the best course of action if the PSA level is high.

When done in addition to a DRE, a PSA blood test enhances detection of prostate cancer. However, the test is known to have relatively high false-positive rates. A PSA blood test also may identify a greater number of medically insignificant lumps or growths, called tumors, in the prostate. Health care providers and patients should weigh the benefits of PSA blood testing against the risks of follow-up diagnostic tests. The procedures used to diagnose prostate cancer may cause significant side effects, including bleeding and infection.

What are additional tests for detecting prostate problems?

If the DRE or the PSA blood test indicates a problem may exist, the health care provider may order additional tests, including urinalysis, urodynamic tests, cystoscopy, abdominal ultrasound, transrectal ultrasound with prostate biopsy, and imaging studies such as magnetic resonance imaging (MRI) or computerized tomography (CT) scan.

Urinalysis

Urinalysis is the testing of a urine sample for abnormal substances or signs of infection. The urine sample is collected in a special container in a health care provider’s office or commercial facility and can be tested in the same location or sent to a lab for analysis.

If an infection is suspected, the health care provider may ask that the urine sample be collected in two or three containers during a single urination to help locate the infection site. After the first collection, the health care provider will have the patient stop the urine stream for a prostate massage before collecting more urine. If signs of infection appear in the first container but not in the others, the infection is likely to be in the urethra. If the urine contains significantly more bacteria after the prostate massage or bacteria are in the prostate fluid itself, the infection is likely to be in the prostate.

Urodynamic Tests

Urodynamic testing is any procedure that looks at how well the bladder, sphincters, and urethra are storing and releasing urine. Most urodynamic tests focus on the bladder’s ability to hold urine and empty steadily and completely. If the prostate problem appears to be related to urine blockage, the health care provider may recommend tests that measure bladder pressure and urine flow rate. One test involves urinating into a special device that measures how quickly the urine is flowing and records how many seconds it takes for the peak flow rate to be reached. Another test measures postvoid residual, the amount of urine left in the bladder when urination stops. A weak urine stream and urinary retention may be signs of urine blockage caused by an enlarged prostate that is squeezing the urethra. Some urodynamic tests are performed in a health care provider’s office without anesthesia. Other urodynamic tests are performed in a health care provider’s office, outpatient center, or hospital with local anesthesia.

Cystoscopy

Cystoscopy is a procedure that allows the health care provider to look for blockage in the lower urinary tract. A cystoscope is a tubelike instrument used to look inside the urethra and bladder. After a solution numbs the inside of the penis, the health care provider inserts the cystoscope through the opening at the tip of the penis and into the lower urinary tract. By looking through the cystoscope, the health care provider can determine the location and degree of the urine blockage. A cystoscopy is performed in a health care provider’s office, outpatient center, or hospital with local anesthesia. The procedure is usually performed by a urologist, a doctor who specializes in treating problems of the urinary tract and the male reproductive system.

Abdominal Ultrasound

Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. The transducer can be moved to different angles to make it possible to examine different organs. In abdominal ultrasound, the health care provider applies a gel to the patient’s abdomen and moves a handheld transducer over the skin. The gel allows the transducer to glide easily, and it improves the transmission of the signals. The procedure is performed in a health care provider’s office, outpatient center, or hospital by a specially trained technician and interpreted by a doctor, usually a radiologist—a doctor who specializes in medical imaging. Anesthesia is not needed. An abdominal ultrasound can create images of the entire urinary tract. The images can show damage or abnormalities in the urinary tract resulting from urine blockage at the prostate.

Transrectal Ultrasound with Prostate Biopsy

Transrectal ultrasound is most often used to examine the prostate. In a transrectal ultrasound, the health care provider inserts a transducer slightly larger than a pen into the man’s rectum next to the prostate. The ultrasound image shows the size of the prostate and any abnormal-looking areas, such as tumors. Transrectal ultrasound cannot definitively identify prostate cancer.

To determine whether a tumor is cancerous, the health care provider uses the transducer and ultrasound images to guide a needle to the tumor. The needle is then used to remove a few pieces of prostate tissue for examination with a microscope. This process, called biopsy, can reveal whether prostate cancer is present. A transrectal ultrasound with prostate biopsy is usually performed by a doctor in a health care provider’s office, outpatient center, or hospital with light sedation and local anesthesia. The biopsied prostate tissue is examined in a laboratory by a pathologist—a doctor who specializes in diagnosing diseases.

Tansrectal ultrasound with prostate biopsy

MRI and CT Scan

An MRI is a test that takes pictures of the body’s internal organs and soft tissues without using x-rays. The MRI machines use radio waves and magnets to produce detailed pictures. An MRI may also involve the injection of dye. A CT scan uses a combination of x-rays and computer technology to create three-dimensional (3-D) images. A CT scan may also involve the injection of a dye. MRI and CT scan images can help identify abnormal structures in the urinary tract, but they cannot distinguish between cancerous tumors and noncancerous prostate enlargement. Once a biopsy has confirmed cancer, these imaging techniques will show how far the cancer has spread. MRIs and CT scans are usually performed at an outpatient center or hospital by a specially trained technician and interpreted by a radiologist; anesthesia is not needed. For an MRI, light sedation may be used for people with a fear of confined spaces.

What happens after the prostate tests?

Urodynamic tests and cystoscopy may cause mild discomfort for a few hours after the procedures. Drinking an 8-ounce glass of water every half-hour for 2 hours may help reduce discomfort. The health care provider may recommend taking a warm bath or holding a warm, damp washcloth over the urethral opening to relieve discomfort. A prostate biopsy may produce pain in the area of the rectum and the perineum, which is between the rectum and the scrotum. A prostate biopsy may also produce blood in urine and semen.

An antibiotic may be prescribed for 1 or 2 days to prevent infection.

Patients with signs of infection—including pain, chills, or fever—should call their health care provider immediately.

How soon will prostate test results be available?

Results for simple medical tests such as some urodynamic tests, cystoscopy, and abdominal ultrasound are often available soon after the test. The results of other medical tests such as PSA blood test and prostate tissue biopsy may take several days to come back. A health care provider will talk with the patient about the results and possible treatments for the problem.

Eating, Diet, and Nutrition

Eating, diet, and nutrition have not been shown to play a role in causing or preventing prostate problems.

Clinical Trials

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions.

What are clinical trials, and are they right for you?

Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for you.

What clinical trials are open?

Clinical trials that are currently open and are recruiting can be viewed at www.ClinicalTrials.gov.

Prostate cancer – NHS

Prostate cancer usually develops slowly, so there may be no signs for many years.

Symptoms of prostate cancer

Symptoms of prostate cancer do not usually appear until the prostate is large enough to affect the tube that carries urine from the bladder out of the penis (urethra).

When this happens, you may notice things like:

• an increased need to pee
• straining while you pee
• a feeling that your bladder has not fully emptied

These symptoms should not be ignored, but they do not mean you have prostate cancer.

It’s more likely they’re caused by something else, such as prostate enlargement.

Information:

Coronavirus advice

Get advice about coronavirus and cancer:

What is the prostate?

The prostate is a small gland in the pelvis and is part of the male reproductive system.

About the size of a walnut, it’s located between the penis and the bladder, and surrounds the urethra.

The main function of the prostate is to produce a thick white fluid that creates semen when mixed with the sperm produced by the testicles.

Causes of prostate cancer

The causes of prostate cancer are largely unknown. But certain things can increase your risk of developing the condition.

The chances of developing prostate cancer increase as you get older. Most cases develop in men aged 50 or older.

For reasons not yet understood, prostate cancer is more common in black men and less common in Asian men.

Men whose father or brother were affected by prostate cancer are at slightly increased risk themselves.

Recent research also suggests that obesity increases the risk of prostate cancer.

Tests for prostate cancer

There’s no single test for prostate cancer.

All the tests used to help diagnose the condition have benefits and risks that your doctor should discuss with you.

The most commonly used tests for prostate cancer are:

Find out more about how prostate cancer is diagnosed

PSA testing

The blood test, called a prostate-specific antigen (PSA) test, measures the level of PSA and may help detect early prostate cancer.

If you are over 50, you can ask a GP for a PSA test.

PSA tests are not routinely used to screen for prostate cancer, as results can be unreliable.

Your PSA level can also be raised by other, non-cancerous conditions.

Raised PSA levels also cannot tell a doctor whether you have life-threatening prostate cancer or not.

If you have a raised PSA level, you may be offered an MRI scan of the prostate to help doctors decide if you need further tests and treatment.

Find out more about PSA screening and testing in the UK

Treating prostate cancer

If you do have prostate cancer, you may not need treatment.

If the cancer is at an early stage and not causing symptoms, your doctor may suggest either “watchful waiting” or “active surveillance”.

The best option depends on your age and overall health. Both options involve carefully monitoring your condition.

Some cases of prostate cancer can be cured if treated in the early stages.

Treatments include:

• surgically removing the prostate
• radiotherapy – either on its own or alongside hormone therapy

Some cases are only diagnosed at a later stage, when the cancer has spread.

If the cancer spreads to other parts of the body and cannot be cured, treatment is focused on prolonging life and relieving symptoms.

All treatment options carry the risk of significant side effects, including erectile dysfunction and urinary symptoms, such as needing to use the toilet more urgently or more often.

For this reason, you may choose to delay treatment until there’s a risk the cancer might spread.

Newer treatments, such as high-intensity focused ultrasound (HIFU) and cryotherapy, aim to reduce these side effects.

Some hospitals may offer them as an alternative to surgery, radiotherapy or hormone therapy.

But the long-term effectiveness of these treatments is not known yet.

Living with prostate cancer

As prostate cancer usually progresses very slowly, you can live for decades without symptoms or needing treatment.

Nevertheless, it can affect your life. As well as the possible side effects of treatment, a diagnosis of prostate cancer can understandably make you feel anxious or depressed.

You may find it beneficial to talk about the condition with your family, friends, a GP and other people with prostate cancer.

Financial support is also available if prostate cancer reduces your ability to work.

Find out more about living with prostate cancer

Video: prostate cancer

In this video, an expert talks about the diagnosis and treatment of prostate cancer.

Media last reviewed: 12 January 2021
Media review due: 12 January 2024

Page last reviewed: 18 October 2021
Next review due: 18 October 2024

Prostatitis treatment | “Medicine” – medical center Perm

Prostatitis is a disease usually caused by inflammation of the prostate gland. An indicator of its presence is problems with urination.

Statistics show that 51% of men in the age group over 35 have a problem.

Prostatitis can progress from a discomforting illness to a serious problem. Long-term untreated results in:

• vesiculitis – inflammation of the seminal vesicles.It causes pain in the groin, especially during urination. And pus and blood appear in the ejaculate;
• urethritis – inflammation of the seminal tubercle. It leads to a complication of sexual life, since acute pain occurs during ejaculation;
• sclerosis of the prostate – the prostate tissue is replaced by scars. As a result, there are problems with urination and the formation of stones in the bladder;
• sexual dysfunctions and infertility.

The best treatment for prostatitis in Perm – Timely appeal to a specialist in our clinic. He will conduct an examination and help you overcome the disease.

How do you know when it’s time to see a doctor?

Listen to your body. Observe the following symptoms:

• pain in the lower abdomen, especially in the perineum and scrotum;
• problems urinating;
• sexual dysfunction;
• problem with ejaculation;
• change in the quantity and quality of ejaculate.

It should be noted that prostatitis can mask well. Some patients are not even aware of its presence. It does not give clear clinical symptoms until the inflammatory process enters the active stage.

Visit our specialist to check the condition of the prostate gland. Depending on her health, he will suggest appropriate treatment measures.

In the clinic “Medicine” you can not only get advice from an urologist-andrologist, but also carry out all the necessary research:

• to do an ultrasound of the prostate and the entire genitourinary system
• pass for tests the secret of the prostate and evacuate
• carry out physiotherapy and massage of the prostate;
• to carry out instillation (administration of drugs into the urethra and bladder), electrical stimulation and LOD – therapy on the “Matrix-Urolog” apparatus

Prostate adenoma – fight against benign growth

Benign prostatic hyperplasia (BPH) is a disease in which a small nodule or nodules form in the prostate gland (in the case of prostatitis, this is inflammation), while the formation gradually increases.

An increase in the size of the prostate gland leads to the same consequences as in prostatitis.

Treatment of BPH is required for a large number of men. Depending on age, from 11.3% to 81.4% of people suffer from it. Anyone can have it and do not manifest themselves at all. But changes in the structure of the prostate gland occur and must be dealt with.

There is no need to fear treatment. The surgical method gradually faded into the background. It is used only in the later stages, when the fastest and most effective intervention is required.Having visited the doctor in a timely manner and passed the examination, you will be able to correctly diagnose and take advantage of drug treatment.

Prostate adenoma or prostatitis? Why should you contact us?

Due to similar symptoms, the two diseases are often confused. And if the treatment is not what is needed, then the disease can be aggravated.

Just contact our specialists and go through the inspection. Prevention and timely treatment are significantly cheaper and less risky than chronic prostatitis.

In the medical center “Medicine” for the treatment of prostatitis you will be received by specialists:

Semenov Vyacheslav Nikolaevich

• Specialist of the highest qualification category;
• More than 20 years of professional experience;
• Trained at the Institutes of Advanced Training for Doctors and the Academies of Postgraduate Education in St. Petersburg, Moscow, Chelyabinsk, Perm in urology, andrology, sexology and sexopathology, psychotherapy and medical psychology;
• Is one of the organizers of the andrological service in the Kama region;
• Supervised the first department of andrology and sexopathology in the Ural region;
• Supervised a private male consultation;
• Member of the Russian Associations of Urologists, Andrologists, Sexologists.

Why is the clinic “Medicine” successfully treating prostatitis?

• Specialists only of the highest qualification category, who have proven their knowledge by hundreds of cured patients;
• You receive personalized treatment;
• we are not marketing partners for drugs and only recommend those drugs that are really needed for treatment;
• all the necessary hygiene nuances (napkins, towels, etc.)) we have taken it into account, you should not worry about it
• reception is not limited in time, our goal is your health, so all attention is on you.

Take care of your health today. Come to us for a consultation, and we will help you to correctly start the prevention and treatment of prostate diseases.

Clinic administrators will contact you during working hours to confirm your visit to the doctor, as well as offer a convenient time for you to make an appointment.

how to find out if there is prostatitis

how to find out if there is prostatitis

Since Urotrin is a native remedy, the number of contraindications is minimal, namely, it is limited by the age range (admission is allowed from the age of 20) and individual intolerance to the components of the composition. Judging by the reviews about Urotrin, this special type of allergy practically does not occur. In addition, the manufacturer has carefully selected the proportions of the components that the risk of allergic manifestations is reduced to zero.

treatment of recurrent prostate cancer, drugs for prostatitis and prostate adenoma
effects of prostatitis
omnic cure for prostatitis and adenoma price
sumamed for prostatitis
how to cure prostate adenoma

How to define prostatitis? This question is asked by men who want to prevent the development of the disease, find out the symptoms. Inflammation of the prostate gland in men can occur against the background of infectious and non-infectious etiology. It is important to know not only the first symptoms. How to define prostatitis? Sooner or later, every man begins to show health problems. How to define prostatitis? This is a question that doctors often ask. After all, timely detection of the disease will allow you to get rid of. How to define prostatitis? This question is asked by men who want to prevent the development of the disease, find out the symptoms. Inflammation of the prostate gland in men can occur against the background of infectious and non-infectious etiology. It is important to know not only the first symptoms.How to define prostatitis? This question is asked by men who want to prevent the development of the disease, find out the symptoms. Inflammation of the prostate gland in men can occur against an infectious background. At the moment, the question of how to define prostatitis worries more than half of men. Now we are talking about representatives of the stronger sex at the age of 30-35 years, but this figure is decreasing. Has the patient had prostatitis before? What adverse factors is a man exposed to at work?How to find out at home: rectal examination. If there is a suspicion that the prostate gland has begun to become inflamed, and there is no way to get an appointment with a urologist. Do you want to know how to define prostatitis and whether it is possible to prevent the development of this disease? Bacteriological analysis is used if the doctor suspects bacterial prostatitis. How to define prostatitis? The disease in acute form has characteristic symptoms. But the chronic form can be asymptomatic for a long time.whether prostatitis has been previously diagnosed; whether there is a regular sexual partner (whether he has had cases of infection with venereal pathologies, whether treatment has been carried out). Every doctor knows how to check the prostate in men.

effects of prostatitis how to find out if there is prostatitis

Treatment of recurrent prostate cancer
medicines for prostatitis and prostate adenoma
effects from prostatitis
omnik medicine for prostatitis and adenoma price
sumamed for prostatitis
how to cure prostate adenoma
Where to buy in Grodno urotrin
blood test for prostate adenoma in men

how to find out if there is prostatitis omnic a cure for prostatitis and adenoma price

Where to buy in Grodno urotrin
blood test for prostate adenoma in men
prestanol for prostatitis
remedy for potency urotrin
treatment of prostatitis drugs reviews
vitafon treatment of prostate adenoma

Urotrin is able to cure all diseases that interfere with normal male sexual health. As you can imagine, men’s health consists of the health of many human organs. That is why many people buy Urotrin, because rarely does anyone suffer from only one specific disease. More often than not, the body is simply completely weakened. And Urotrin just copes with the function of treating these problems. The composition of the natural complex is selected in such a way that it is able to eliminate such signs of prostatitis as frequent and painful urination, to reduce the likelihood of the spread of infection in the genitourinary sphere.Biologically active components act directly on the site of inflammation, acting as an antibiotic. At the same time, they do not kill the beneficial microflora, like most synthetic drugs. Urotrin is able to cure all diseases that interfere with normal male sexual health. As you can imagine, men’s health consists of the health of many human organs. That is why many people buy Urotrin, because rarely does anyone suffer from only one specific disease. More often than not, the body is simply completely weakened. And Urotrin just copes with the function of treating these problems.

Prostate Secretion Analysis | Medical clinic “MEDEXPERT”

90,000 symptoms and treatment, diagnosis and consequences

Stock! Discount 20% on the first doctor’s appointment for new patients of the clinic with the promo code “FIRST20”.

Inflammatory process in the prostate gland is a urological disease called prostatitis. The most common urological disease that affects only men.

The full sexual life of every man, erectile function, activity, efficiency, quality of life depends on the normal functioning of the prostate gland. Exacerbation of prostatitis also affects the ability of men to fertilize: the quality of sperm deteriorates.The disease can cause infertility (infertility). The discomfort caused by chronic prostatitis is compared by doctors to the discomfort of severe tachycardia.

The disease can and must be cured. A modern approach to treatment allows you to quickly relieve symptoms. It is important that you will not only get rid of the inflammatory processes of the prostate gland and be able to prevent relapses, but also gain strength, feel cheerful and strengthen the body.

The main stages of the treatment of chronic prostatitis:

• First of all, doctors select the optimal therapy with the latest antibiotics in order to eliminate the main cause: pathogenic microflora in the prostate gland, and not to weaken the body by the effects of medications.
• Regardless of the identified pathogen (infection), a condom must be used for the period of treatment. If the cause of the inflammation is sexually transmitted diseases, then the sexual partners also need to undergo examination and treatment.
• During severe pain, drugs are prescribed to help relax muscles and relieve pain. Anti-inflammatory drugs are used to relieve inflammation, which relax the neck of the bladder and increase bladder contractility, which makes it easier to urinate.
• Physiotherapy methods are selected individually, they enhance the effect of drugs, and accelerate the healing process. In the treatment are used: laser therapy, thermotherapy, electrical stimulation, electrophoresis, rectal massage, LOD therapy, magnetotherapy, microwave therapy.
• For effective treatment of prostatitis with a subsiding exacerbation and the absence of contraindications, massage of the prostate gland is used – one of the most effective means, especially for congestive prostatitis.
• General strengthening treatment aimed at restoring immunity and preventing recurrence of the disease.

Prostate inflammation is not something to be ignored. And even more so in this case, it is unacceptable to self-medicate.

Inflammation of the prostate negatively affects the sex life of men. The result can be a deterioration in family relationships and the development of severe depression.

Prostate inflammation can and should be treated.But only a qualified doctor should do this. The specialists of the medical center Kutuzovskiy do an excellent job of solving this problem. We are well aware of how delicate this topic is for a man, therefore, at the appointment, the doctor will show maximum attention and understanding. Do not be alone with trouble. Come to the Kutuzov Medical and Diagnostic Center to regain your health and joy of life.

How to avoid re-inflammation

All men are susceptible to prostatitis; the peak incidence occurs between the ages of 20 and 40.

Lifestyle can contribute to the development of chronic prostatitis – for example, promiscuous sexual intercourse without protection and adherence to the rules of personal hygiene, cause infection of the genitourinary organs, and vice versa, irregular sex life can cause stagnation of prostate secretions.

Contributes to the onset of the disease:

• stagnation of prostate secretion (irregular sex life),
• sedentary lifestyle,
• lack of vitamins in food,
• carrying out transurethral manipulations without prophylactic antibiotic therapy,
• chronic hypothermia.

Recommendations for natural prevention of prostatitis:

• regular sex life,
• active lifestyle,
• strengthening of immunity,
• avoid hypothermia,
• do not abuse alcohol,
• use a condom.

When to see a doctor

Treatment of prostatitis is often delayed, diagnosis is left for later, being afraid to admit the presence of the disease. But a delicate problem requires attention, as it can cause infertility, and sometimes bring the patient to the surgical table.

Be attentive to the symptoms of this insidious ailment:

• pain in the lower abdomen, perineum, scrotum,
• urination problems – frequent and painful urination,
• problems with potency (erectile dysfunction),
• change in the quality and quantity of ejaculate,
• ejaculation disorder (accelerated or painful ejaculation),
• feeling of incomplete emptying of the bladder,
• deterioration or lack of orgasm,
• increased irritability.

Diagnosis of prostatitis

To detect the disease and determine the degree of changes in the gland, a high-quality comprehensive diagnosis is required. The development of prostatitis is often accompanied by other diseases: adenoma, hemorrhoids, chronic tonsillitis, sexually transmitted diseases. The urologist will definitely carry out differential diagnostics.

Comprehensive urological examination includes:

• Rectal digital examination
• TRUS of the prostate,
• Ultrasound of the bladder,
• urethral swab
• PCR diagnostics,
• microscopic examination of prostate secretions,
• bacteriological culture of prostate secretion,
• uroflowmetry
• general urine analysis.

Diagnosis of prostate diseases is necessary, even if there are no obvious symptoms of the disease. When the first signs appear, you need to make an appointment with a doctor as soon as possible. Kutuzov Medical Center conducts a comprehensive examination of the body, which makes it possible to assess the risks of the development of pathologies. You can also visit a specialist for a thorough examination of the work of the genitourinary system. All manipulations are carried out on modern equipment under the supervision of experienced specialists. Come for an appointment at the Kutuzov Medical and Diagnostic Center. Here you will receive quality treatment and comprehensive recommendations for the prevention of chronic prostatitis.

For the timely diagnosis and effective treatment of chronic prostatitis, it is recommended to consult a therapist and urologist. In the medical center “Kutuzovsky” you can also undergo a comprehensive examination program recommended for all men over 25 to maintain reproductive function.

Prices

Publication checked by:

.