How Do You Get Tested For Prostate Cancer?

Many prostate cancers are not aggressive and remain contained in the gland, but some are aggressive and can spread throughout the body quickly. It is, therefore, important to diagnose and treat prostate cancer as soon as possible to ensure the best chances for success. Treating early-stage prostate cancers generally results in a good outcome.

 

When Should You Get Screened For Prostate Cancer?

Cancer of the prostate is one of the most common types of cancer, with about 1 in 8 men getting it. You should be tested for prostate cancer if you have a higher risk of developing it. You are more likely to get prostate cancer if:

• You are older than age 50
• You are of black ethnicity
• You are obese
• Your father or brother have had it
• Your mother or sister has had breast cancer

 

Early screening is essential as it can identify cancer early before symptoms develop. If you develop any of the following symptoms, you should get tested for prostate cancer, as these symptoms may be indicative of more advanced cancer:

• Trouble urinating
• Decreased force in the stream of urine
• Blood in urine
• Blood in semen
• Bone pain
• Losing weight without trying
• Erectile dysfunction

How Do You Test For Prostate Cancer?

There is no single, definitive test for prostate cancer. Your doctor will usually recommend tests based on your age, ethnicity and family history and discuss the pros and cons of these various tests.

 

Preliminary tests for prostate cancer usually include:

• Taking a urine sample to check for infection
• Taking a blood sample to test your level of prostate-specific antigen (PSA)  
• Performing a digital rectal examination by inserting a finger into your anus

 

Prostate-specific Antigen (PSA) Test

PSA is a molecule that occurs naturally in the prostate gland, and there is always a small amount in your blood. Blood tests that show higher than normal levels of PSA, may indicate a prostate issue, such as enlargement, inflammation, infection or possibly cancer.

Routinely screening all men to check their prostate-specific antigen (PSA) levels is a controversial subject in the medical community. This is largely due to the unreliability of PSA tests which are known to produce both false-positive and false-negative results. For example, around 1 in 7 men with normal PSA levels may have prostate cancer.

 

Digital Rectal Exam (DRE)

During a DRE, a doctor physically examines your prostate by inserting a lubricated, gloved finger into your rectum, which is next to the prostate. Any abnormalities felt in the gland, such as an odd shape, texture or size, may need additional testing.

 

Advanced Testing For Prostate Cancer

The doctor will assess your risk of having prostate cancer based on several factors, including your PSA levels and the results of your prostate examination, as well as your age, family history and ethnic group.

If you have a raised PSA level, your doctor may refer you for an MRI scan of your prostate. If the scan shows a problem, it can be targeted later with a biopsy.

MRI Scan

Due to the limitations of PSA blood tests, most men are now offered an MRI scan before further tests and treatment.

Biopsies To Diagnose Prostate Cancer

Tissue taken from a prostate biopsy are studied in a laboratory. If cancerous cells are detected, they can be studied further to determine how quickly the cancer will spread. Biopsy results will indicate the staging and grading of the cancer and help doctors decide which treatment is the most appropriate.

 

There are a few types of biopsy, including the following:

Transperineal Biopsy

During this procedure, which is done under general anaesthetic, a needle is inserted into the prostate through the skin behind the scrotum. It has the advantage of a reduced risk of infection.

Transrectal Biopsy

During this biopsy, an ultrasound probe is inserted into your rectum. This allows the doctor to see where to insert the needle to take small samples of tissue from your prostate. This procedure is normally done using a local anaesthetic.

Possible Problems With Biopsies

Although a biopsy is more reliable than a PSA test, there can carry risks, such as:

• Missing the cancer
• Another biopsy if your symptoms persist or your PSA level continues to rise
• Undergoing unnecessary surgery or radiotherapy based on finding small, low-risk cancers that do not need treatment
• Incontinence and,
• Erectile dysfunction (impotence)

Testing For Advanced Prostate Cancer

If symptoms and screening results indicate a significant chance that the cancer has spread from your prostate to other parts of the body, further tests may be recommended.

These tests include a:

• MRI scan
• CT scan
• PET scan – these scans build a detailed picture of the inside of your body, and
• Isotope bone scan, which can tell if the cancer has spread to your bones