Mayo Clinic Health Manager
Get free personalized health guidance for you and your family.
Get Started
About our e-newsletters
- Free e-newsletters
- Mayo Clinic expertise
- We do not share your e-mail address
Housecall, our weekly general-interest e-newsletter, keeps you up to date on a wide variety of health topics with timely, reliable, practical information, recipes, blogs, questions and answers with Mayo Clinic experts and more. Our biweekly topic-specific e-newsletters also include blogs, questions and answers with Mayo Clinic experts, and other useful information that will help you manage your health.
Housecall Archives
Mayo Clinic Housecall
Stay up to date on the latest health information.
What you get
- Free weekly e-newsletter
- Mayo Clinic expertise
- Recipes, tools and other helpful information
- We do not share your e-mail address
Tests and diagnosis
By Mayo Clinic staff
Screening for prostate cancer
Most prostate cancer is discovered through routine screening. Still, testing men who have no prostate symptoms for prostate cancer is controversial. Medical organizations don't agree on the issue of screening and whether it has benefits. Some medical organizations recommend men begin prostate cancer screening in their 50s, or sooner for men who have risk factors for prostate cancer. Other organizations advise against screening. Discuss your particular situation and the benefits and risks of screening with your doctor. Together you can decide whether prostate cancer screening is appropriate for you.
Prostate screening tests might include:
- Digital rectal exam (DRE). During a DRE, your doctor inserts a gloved, lubricated finger into your rectum to examine your prostate, which is adjacent to the rectum. If your doctor finds any abnormalities in the texture, shape or size of your gland, you may need more tests.
- Prostate-specific antigen (PSA) test. A blood sample is drawn from a vein in your arm and analyzed for PSA, a substance that's naturally produced by your prostate gland. It's normal for a small amount of PSA to enter your bloodstream. However, if a higher than normal level is found, it may be an indication of prostate infection, inflammation, enlargement or cancer.
PSA testing combined with DRE helps identify prostate cancers at their earliest stages, but studies haven't proven that these tests save lives. For that reason, there is much debate surrounding prostate cancer screening.
Diagnosing prostate cancer
If an abnormality is detected on a DRE or PSA test, your doctor may recommend tests to determine whether you have prostate cancer, such as:
- Ultrasound. If other tests raise concerns, your doctor may use transrectal ultrasound to further evaluate your prostate. A small probe, about the size and shape of a cigar, is inserted into your rectum. The probe uses sound waves to make a picture of your prostate gland.
- Collecting a sample of prostate tissue. If initial test results suggest prostate cancer, your doctor may recommend a procedure to collect a sample of suspicious cells from your prostate (prostate biopsy). Prostate biopsy is often done using a thin needle that's inserted into the prostate to collect tissue. The tissue sample is analyzed in a laboratory to determine whether cancer cells are present.
Determining whether prostate cancer is aggressive
When a biopsy confirms the presence of cancer, the next step, called grading, is to determine how aggressive the cancer is. The tissue samples are studied, and the cancer cells are compared with healthy prostate cells. The more the cancer cells differ from the healthy cells, the more aggressive the cancer and the more likely it is to spread quickly. More aggressive cancer cells have a higher grade.
The most common scale used to evaluate the grade of prostate cancer cells is called a Gleason score. Scoring can range from 2 (nonaggressive cancer) to 10 (very aggressive cancer).
Determining how far the cancer has spread
Once a cancer diagnosis has been made, your doctor works to determine the extent (stage) of the cancer. Many men won't require these additional tests. But if your doctor suspects your cancer may have spread beyond your prostate, imaging tests such as these may be recommended:
- Bone scan
- Ultrasound
- Computerized tomography (CT) scan
- Magnetic resonance imaging (MRI)
Once testing is complete, your doctor assigns your cancer a stage. This helps determine your treatment options. The prostate cancer stages are:
- Stage I. This stage signifies very early cancer that's confined to a microscopic area that your doctor can't feel.
- Stage II. Your cancer can be felt, but it remains confined to your prostate gland.
- Stage III. Your cancer has spread beyond the prostate to the seminal vesicles or other nearby tissues.
- Stage IV. Your cancer has spread to lymph nodes, bones, lungs or other organs.
- Nelson WG, et al. Prostate cancer. In: Abeloff MD, et al. Abeloff's Clinical Oncology. 4th ed. Philadelphia, Pa.: Churchill Livingstone; 2008:1653.
- Prostate cancer. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/PDF/prostate.pdf. Accessed Jan. 6, 2010.
- What you need to know about prostate cancer. National Cancer Institute. http://www.cancer.gov/cancertopics/wyntk/prostate/allpages/print. Accessed Jan. 7, 2010.
- Loeb S, et al. Risk factors, prevention and early detection of prostate cancer. Primary Care: Clinics in Office Practice. 2009;36:603.
- Prostate cancer early detection. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/PDF/prostate_detection.pdf. Accessed Jan. 6, 2010.
- Prostate cancer prevention (PDQ) health professional version. National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/prevention/prostate/healthprofessional/allpages/print. Accessed Jan. 7, 2010.
- Urinary dysfunction. Prostate Cancer Foundation. http://www.prostatecancerfoundation.org/side_effects/urinary_dysfunction. Accessed Jan. 11, 2010.
- Erectile dysfunction. Prostate Cancer Foundation. http://www.prostatecancerfoundation.org/side_effects/erectile_dysfunction. Accessed Jan. 11, 2010.
- Surgical management of prostate cancer. American Urological Association Foundation. http://www.urologyhealth.org/adult/index.cfm?cat=04&topic=130. Accessed Jan. 11, 2010.
- McClure MW. Prostate cancer. In: Rakel D. Integrative Medicine. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/178018505-4/0/1494/0.html. Accessed Jan. 11, 2010.
- Distress management. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/PDF/distress.pdf. Accessed Jan. 11, 2010.
- Castle EP (expert opinion). Mayo Clinic, Scottsdale/Phoenix, Ariz. Jan. 23, 2010.
- Dawson NA. Overview of treatment for advanced prostate cancer. http://www.uptodate.com/home/index.html. Accessed Jan. 25, 2010.
- Cryoablation for prostate cancer. UrologyHealthy.org. http://www.urologyhealth.org/adult/index.cfm?cat=04&topic=42. Accessed Jan. 25, 2010.
- Ahmed HU, et al. Minimally-invasive technologies in uro-oncology: The role of cryotherapy, HIFU and photodynamic therapy in whole gland and focal therapy of localised prostate cancer. Surgical Oncology. 2009;18:2189.
- Found 332 studies with search of: Prostate cancer AND chemotherapy. ClincalTrials.gov. http://www.clinicaltrials.gov/ct2/results?term=prostate+cancer+AND+chemotherapy. Accessed Jan. 25, 2010.
