Diagnosing Prostate Cancer
In addition to regular physical examinations that include blood, urine, and possibly other laboratory tests, many groups such as the American Cancer Society suggest talking with your doctor to learn more about the pros and cons of screening for prostate cancer to help you decide if it is right for you. The tests used for screening include:
- DRE (digital rectal examination)
A physician or nurse places a gloved and lubricated finger into the rectum to examine the rectum and feel the prostate gland. DREs may be conducted annually for men over the age of 50 who choose to be screened. Men in high-risk groups, such as African Americans, or those with a strong family history of prostate cancer, should consult their physician about being tested at a younger age or more often. - PSA (prostate-specific antigen)
PSA is a blood test that measures the level of prostate specific antigen. The use of PSA in clinical practice was pioneered here at Stanford. PSA is a substance produced by the prostate gland, which may be found in higher amounts in men who have prostate cancer. The PSA test may be done annually for men over the age of 50 who choose to be screened. Men in high-risk groups, such as African Americans, or those with a strong family history of prostate cancer, should consult their physician about being tested at a younger age or more often.
If the results of the DRE or PSA are unusual, your physician may repeat the tests or request other procedures. These evaluation tools may include:
- prostate biopsy - a test in which where the doctor inserts thin, hollow needles into the prostate to get samples for examination under a microscope to determine if cancer cells are present. The methods of prostate biopsy were developed by Stanford researchers.
- transrectal ultrasound (TRUS) - a test using sound wave echoes to create an image of the prostate gland to visually inspect for abnormal conditions. A transrectal ultrasound can show if the prostate gland is enlarged or if there are any growths in or around the prostate. Ultrasound may also be used to guide a needle for biopsies of the prostate gland and/or to guide the nitrogen probes in cryosurgery.
- computed tomography scan (CT or CAT scan) - a diagnostic imaging procedure test that uses a combination of X-rays and computer technology to produce cross-sectional images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than standard X-rays.
- magnetic resonance imaging (MRI) - a diagnostic test that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.
- radionuclide bone scan - a nuclear imaging method that helps to show whether the cancer has spread from the prostate gland to the bones. The test involves injecting a radioactive material into a vein that helps to locate diseased bone cells throughout the entire body.
- lymph node biopsy - a procedure in which tissue samples are removed (with a needle or during surgery) from the lymph nodes for examination under a microscope; to determine if cancer or other abnormal cells are present.
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