Prostate Cancer Diagnosis and Staging

Timely prostate cancer diagnosis is crucial for treating it successfully. However, prostate cancer varies with each individual person. Some are very slow-growing and never need treatment; others can be life-limiting.

Tests to Diagnose Prostate Cancer

If your physician suspects you might have prostate cancer, you will be asked about 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 family history. You’ll also need tests and examinations to confirm the diagnosis. These might include:

Digital Rectal Examination

The first step in the diagnosis of prostate cancer is an examination of the prostate. The doctor inserts a lubricated, gloved finger into the rectum and assesses the prostate through the rectal wall for abnormal lumps.

Prostate-Specific Antigen (PSA) Test

This is a test that measures the level of PSA in the blood. PSA is a substance produced by the prostate that may be found in greater than normal amounts in the blood of men who have prostate cancer. PSA levels may also be high in men who have an inflammation or infection of the prostate or Benign Prostatic Hyperplasia (BPH).

Prostate Biopsy

A procedure in which an ultrasound probe that is about the size of a finger is inserted into the rectum to check the prostate. Under ultrasound guidance, tissue samples of the prostate are removed by a thin needle either through the rectum or the perineum. In some patients, biopsy may be done under MRI guidance for more accurate location of areas of the prostate that contain cancer. Samples are submitted for assessment by a pathologist.

Staging

Magnetic Resonance Imaging (MRI)

MRI is done to assess the extent of cancer spread into surrounding structures and lymph nodes.

Bone Scan

It helps to detect if the cancer has spread from the prostate to the bones.

CT Scan

CT scan is performed to detect any spread of the cancer to lymph nodes. Less commonly, aggressive cases of prostate cancer may spread to the liver and lungs.

PSMA PET Scan

These are the most sensitive scans available to assess for cancer spread to lymph nodes, bones and other solid organs.

After diagnostic tests are done, your doctor will review all of the results with you. If the diagnosis is prostate cancer, these results also help the doctor describe the cancer. This is called staging.

[Updated 12 Aug 22]

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