Since the prostate is close to the rectum, the physician can feel for abnormalities on the surface of the prostate by examining the patient's rectum. During the digital rectal exam (DRE), the physician feels the size and shape of the prostate gland for irregularities that may require further testing.

PSA Blood Test

Men with prostate glands have PSA (Prostate Specific Antigen) in their blood. An abnormally high PSA (greater than 4 ng/ml) may indicate the presence of prostate cancer. The PSA can also be elevated with benign enlargement of the prostate (BPH) or with inflammation of the prostate (prostatitis). In general, it is recommended that a PSA blood test be performed starting at age 50.

Prostate Biopsy

If either the digital rectal exam or the PSA value is abnormal, your physician may request that a prostate biopsy be performed to rule out prostate cancer. During this exam, your physician will remove a small sample of the prostate to determine if it contains cancerous cells. If cancerous cells are found, the pathologist will "score" them through a system called the Gleason Score. This gives a result between 2-10 and generally reflects the aggressiveness of the cancer cells.

Transrectal Ultrasound

The Transrectal Ultrasound (TRUS) is a test that shows the size and shape of the prostate. It can also help identify areas within the prostate that appear abnormal. This test is performed by inserting a probe into the rectum to transmit pictures of the prostate.

Established Diagnosis

When the diagnosis of Prostate Cancer is established by the biopsy, your physician may request that either a CT scan and/or Bone Scan be performed to make sure that the disease has not spread beyond the prostate. Other tests that may give helpful information include an MRI study of the prostate or a PET scan.

In general, these tests may be helpful but in patients with a favorable PSA and Gleason score, they may not be necessary.

Currently, most men are diagnosed with early stage, localized prostate cancer where the risk of spread beyond the prostate gland is quite low. This affords the patients an opportunity to select various definitive treatment options with the intent to cure and eradicate the disease permanently. In patients with advanced prostate cancer, where the disease is spread beyond the prostate gland to either lymph nodes or bones, the treatment modalities are different than that for localized cancer.

Prostate cancer is generally a slow growing cancer. A patient initially diagnosed with prostate cancer, unlike some other types of cancers, will have time to make an informed decision regarding treatment without the fear of the disease spreading. Being comfortable with a treatment decision is possibly more important than the treatment itself.