Screening

Screening for Prostate Cancer

Prostate cancer screening tests determine if a patient has prostate cancer before it causes symptoms. Although a delayed onset of symptoms can complicate an early stage prostate cancer diagnosis, regular physical exams and screening tests have helped doctors with prostate cancer detection, allowing them to identify the condition in time. A routine prostate cancer test may include Digital Rectal Exams (DRE) and a Prostate-Specific Antigen (PSA) Test.

Digital Rectal Exams (DRE)

A routine exam performed in the doctor’s office to examine the size, shape, and texture of the prostate gland. Using a gloved, lubricated finger, your doctor will feel the prostate for any hard, lumpy, or abnormal areas.

Prostate-Specific Antigen (PSA) Test

A blood test that analyzes a blood sample for concentrations of PSA, which is a blood protein produced by the prostate gland. High PSA levels in the sample indicate a problem with the prostate and the need for further testing.

High PSA levels do not necessarily mean that you have prostate cancer. Other factors, such as an enlarged prostate (benign prostatic hyperplasia), old age, riding a bicycle and ejaculation may also be responsible for elevated PSA levels.) If abnormalities are present during the DRE or PSA test, a physician will order further testing such as:

  • Transrectal ultrasound: An outpatient procedure that requires the insertion of a small probe via the rectum in order to get an image of the prostate.
  • Prostate biopsy: An outpatient procedure that gathers and tests a small sample of prostate tissue to determine whether the prostate contains cancerous cells.

The completion of these tests will allow doctors to definitively confirm or deny the presence of prostate cancer. A physician may also perform additional ultrasounds, X-rays, or biopsies to determine whether the prostate cancer has spread to other areas of the body.

If your doctor decides to take a biopsy and it comes back positive, a pathologist will then assign a Gleason score  to the prostate cancer. Each score is on a 1 – 5 scale and the numbers are added to get your total score.

Here is how to understand your Gleason score:

  • 2 to 4 means that your cancer is not very aggressive.
  • 5 to 6 means your cancer is mildly aggressive.
  • 7 means that your cancer is moderately aggressive.
  • 8 to 10 means that your cancer is highly aggressive.