Prostate cancer is one of the most common cancers among men, and in many cases, it develops slowly over time. Because early-stage prostate cancer often does not cause noticeable symptoms, screening plays an important role in detecting the disease when it is most treatable. Understanding how prostate cancer is found and diagnosed can help you make informed decisions about your health.
Prostate Cancer Screening
Screening is used to look for signs of prostate cancer before symptoms develop. Not every man needs to be screened at the same time, so it’s important to talk with your doctor about your personal risk and when screening should begin.
The Right Timing for Prostate Cancer Screening
According to the American Cancer Society, men should have a conversation with their doctor about prostate cancer screening based on their age and risk factors. Men at average risk typically begin discussing screening around age 50. Those at higher risk, including African American men or men with a family history of prostate cancer, should talk to their doctors sooner.
PSA Blood Test to Screen for Prostate Cancer
PSA is a protein produced by the prostate gland, and higher levels in the blood can sometimes be a sign of cancer. It can also be a sign of other non-cancerous conditions. If the PSA test results are higher than normal, your doctor will likely have you retest in several months to see if it continues to rise. A steady increase may lead to further testing.
Digital Rectal Exam (DRE)
A digital rectal exam is another screening method that allows the doctor to physically examine the prostate. During this exam, a provider gently inserts a gloved finger into the rectum to feel the prostate for any lumps, hard areas, or irregularities.
While the DRE is less commonly used on its own, it can provide additional information when combined with an elevated PSA test.
Prostate Cancer Diagnosis
If there is concern based on screening results, the next step is a diagnostic evaluation. These tests are designed to confirm whether cancer is present and, if so, determine how aggressive it may be.
Imaging Tests
Before a biopsy, imaging tests may be used to take a closer look at the prostate. A multiparametric MRI is one of the most common tools used today. This imaging can help identify suspicious areas within the prostate and guide the biopsy to improve accuracy.
In some cases, ultrasound imaging may also be used, particularly during the biopsy procedure.
Prostate Biopsy to Diagnose Cancer
A biopsy is the only way to definitively diagnose prostate cancer. This procedure is typically performed by a urologist.
During a prostate biopsy, several small samples of tissue are taken from different areas of the prostate using a thin needle. Imaging guidance, such as ultrasound or MRI, helps ensure that the samples are taken from the most relevant areas.
The tissue samples are then sent to a pathologist, who examines them under a microscope to determine whether cancer cells are present.
Gleason Scoring Based on Biopsy
If cancer is found, the next step is to evaluate how aggressive it is. This is done using the Gleason scoring system, which looks at how different the cancer cells appear under the microscope compared to normal prostate cells.
The pathologist assigns two scores to the most predominant cell patterns seen in the samples. The higher the number, the more abnormal the cells. These grades are added together to create a Gleason score between 2 and 10.
Learn more about the Gleason score and prostate cancer staging.
Additional Testing After Diagnosis
If prostate cancer is confirmed, additional tests may be performed to determine whether it has spread beyond the prostate. These may include advanced imaging studies such as CT scans, bone scans, or PET scans.
Doctors may also evaluate PSA levels again and consider other factors, such as the number of biopsy samples containing cancer, to better understand the extent of the disease.
This process, known as staging, helps guide the most appropriate treatment plan.
Why Early Detection Matters
Prostate cancer found at an early stage is often highly treatable. In many cases, it grows slowly, giving patients time to carefully consider their options. Some men may not need immediate treatment and can be safely monitored through active surveillance.
For others, early detection allows treatment to begin before the cancer spreads, improving outcomes and expanding available treatment options.
Learn more about prostate cancer treatments.
Prostate Cancer Care at Blue Ridge Cancer Care
If you or a loved one was recently diagnosed with prostate cancer, it’s helpful to visit with a prostate cancer oncologist in addition to the urologist to review treatments other than surgery that may be available to you. Our team is dedicated to providing the most advanced cancer treatments, including access to clinical research trials. Request an appointment at one of our Roanoke Valley locations to discuss your options.
