There is no single, simple test to detect prostate cancer. There is also no way to test whether your prostate cancer will grow slowly or fast.
Tests used to diagnose prostate cancer include:
- digital rectal examination
- prostate specific antigen test
- prostate biopsy.
Digital rectal examination
This involves your doctor inserting a gloved finger into your rectum to feel your prostate. It is possible to tell if the prostate is enlarged, but it is not possible to feel the entire prostate. A small cancer, or one that is out of reach, may be missed.
Prostate specific antigen (PSA) test
This involves a blood test to measure the amount of prostate specific antigen (PSA) in your blood. Most of the PSA in your body is made by the prostate and forms part of semen. When the prostate is damaged, PSA leaks into the blood. PSA levels typically increase with age, as the prostate ages. Generally, a value around 4 ng/ml or less is considered to be in the normal range.
The most likely cause of high PSA levels is some form of prostate disease. PSA can be raised in a range of benign (non-cancer) conditions, such as benign prostatic hyperplasia (BPH) and prostatitis (inflammation of the prostate). It is also raised in prostate cancer. However, most men with elevated PSA levels do not have prostate cancer and some men with prostate cancer do not have elevated PSA levels.
Prostate biopsy
If the digital rectal exam or PSA test indicate that prostate cancer may be present, a prostate biopsy will be carried out. In this procedure, a trans-rectal ultrasound (TRUS) probe is placed in the rectum to give a picture of the prostate. Then, using the ultrasound picture as a guide, a needle is inserted through the wall of the rectum into the prostate and several tissue samples are taken. The tissue samples are examined in a laboratory for signs of prostate cancer. There is a risk of infection and bleeding associated with having a prostate biopsy and it is normal for a course of antibiotics to be prescribed.
Is screening available for prostate cancer?
Presently, it is not clear from a number of international trials whether the benefits of population screening for prostate cancer outweigh any harm. Therefore, based on the current evidence, many experts do not support routine screening for prostate cancer.
Men need to make their own decision about whether to be tested or not, after weighing up the pros and cons of PSA testing.
If you have the symptoms of prostate cancer, there is no doubt you need to see your doctor straight away to be tested.