Diagnosing Prostate Cancer

Early diagnosis of prostate cancer is critical for establishing the best treatment plan for optimal results.

Prostate Cancer Screening Leads to Early Diagnosis

To determine if a man is at risk for prostate cancer, doctors use a simple blood test called a Prostate Specific Antigen (PSA) test. This can be performed right in your primary care physician’s office. For most men, annual PSA testing combined with a digital rectal exam (DRE) should begin at age 50. However, African-American men should begin at age 45, and men with a family history of prostate cancer should begin getting tested at age 40. Your doctor will discuss with you the best prostate cancer screening schedule based on your risk factors.

Prostate Cancer Symptoms Should Always Be Evaluated by a Doctor

If you are experiencing urinary changes or prostate type changes, you should schedule an appointment with a urologist, regardless of your prostate cancer screening schedule. Some symptoms that could be a sign of prostate cancer include:

  • Blood in urine

  • Blood in semen

  • Unexplained weight loss

  • Erectile dysfunction

  • Bone pain (typically associated with advanced prostate cancer)

If you notice any of the symptoms listed above, reach out to your doctor right away. Keep in mind, these symptoms can also be associated with other health conditions that require proper diagnosis by a urologist.

Is a weak urine stream a prostate cancer symptom?

Prostate cancer rarely causes any urine symptoms, such as a weak, slow stream. The urinary symptoms are normally caused by compression (squeezing) of the urethra due to an enlarged prostate, called Benign Prostatic Hyperplasia (BPH). This can be treated by a urologist, but is not typically associated with prostate cancer.

Understanding PSA Levels

It’s important to understand what PSA levels are and what they mean as far as a prostate cancer diagnosis goes. Prostate Specific Antigen, PSA, is an enzyme produced only by prostate cells, either normal or cancerous, and secreted into the seminal fluid to keep it liquefied. A small amount of PSA is leaked into the bloodstream by healthy prostate cells, which allows it to be measured. When a prostate cell is cancerous, it leaks more PSA into the bloodstream. On average, one cancerous prostate cell will produce ten times more PSA than a healthy cell. When cancerous cells multiply, this causes a man’s PSA level to rise.

What Happens if PSA Levels Are Above Normal?

PSA is measured through nanograms per milliliter of blood (ng/ml). Abnormal PSA levels are defined as:

  • Higher than 4.0 ng/ml for men over age 60

  • Higher than 2.4 ng/ml for men 60 and under

The higher the PSA level means that more cancer is present; however, prostate cancer has been found in men with “normal” PSA. If the PSA level is above normal, or the digital rectal exam causes concern, a prostate biopsy may be the next step in determining if cancer is present.

A urologist performs a prostate biopsy by inserting tiny needles into the prostate to remove samples of cells that are tested for prostate cancer. The urologist must get a tissue sample from many different areas of the prostate to fully evaluate whether cancer is present. That’s why a 12-needle prostate cancer biopsy is typically used.

Prostate cancer can typically be categorized in one of three steps of growth

  1. The first step is the development of prostate cancer and growth inside the prostate gland. For reasons unknown, one or more normal prostate cells transform into prostate cancer cells and begin to grow. The hallmark of any cancer is cancer cell growth – reproduction or making more cancer cells. For a long time, prostate cancer grows only inside the prostate and is contained by the prostate's capsule.

  2. Cancer cell leakage through the capsule outside the prostate, which is officially called microscopic capsule penetration. Depending upon the treatment method, prostate cancer treatment has a high success rate in either Step 1 or Step 2.

  3. If undiagnosed or left untreated, Step 3 will eventually occur. This is the spread of prostate cancer (metastasis) beyond the area of the prostate, such as lymph nodes, bones, lungs, or any other place in the body.

Discover the Right Prostate Cancer Treatment Plan for You

The proper treatment plan for prostate cancer is essential for a better chance of recovery. If you have been recently diagnosed with prostate cancer, it’s critical to personally research prostate cancer treatment options to make an informed decision that is best for you and your family. And, with few exceptions, your first treatment method gives you the best chance for success. Request our free guide to learn more about treatment options or talk with a Prostate Cancer Nurse Patient Navigator who can assist in setting up a consultation with a Radiation Oncologist.


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