Prostate Cancer

Screenings can help catch prostate cancer early. If you’re average risk, you’ll probably have your first screening test at age 55. You may need earlier screenings if you’re in a high-risk group. Screenings usually stop after age 70.

You may need additional tests or procedures if screenings show you may have prostate cancer.

Screening tests for prostate cancer

Screening tests can show whether you have signs of prostate cancer that require more testing:

• Digital rectal exam: Your provider inserts a gloved, lubricated finger into your rectum and feels your prostate gland. Bumps or hard areas may mean cancer.
• Prostate-specific antigen (PSA) blood test: The prostate gland makes a protein called protein-specific antigen (PSA). High PSA levels may indicate cancer. Levels also rise if you have benign conditions, such as BPH or prostatitis.

Diagnostic procedures for prostate cancer

Not everyone who likely has prostate cancer will need a definitive diagnosis. For example, if your provider thinks your tumor is growing slowly, they may delay more testing because it’s not serious enough to require treatment. If it’s more aggressive (growing fast or spreading), you may need additional tests, including a biopsy.

• Imaging: An MRI or a transrectal ultrasound can show images of your prostate gland, including suspicious areas that may be cancer. Imaging results can help your provider decide whether to perform a biopsy.
• Biopsy: During a needle biopsy, a healthcare provider removes a tissue sample for testing in a lab for cancer. A biopsy is the only sure way to diagnose prostate cancer or know for certain how aggressive it is. Your provider may perform genetic tests on the biopsied tissue. Some cancer cells have characteristics (like mutations) that make them more likely to respond to specific treatments.

What are the grades and stages of prostate cancer?

Healthcare providers use the Gleason score and cancer staging to determine how serious the cancer is and the types of treatments you need.

Gleason score

The Gleason score allows your provider to rate how abnormal your cancer cells are. The more abnormal cells you have, the higher your Gleason score. The Gleason score allows your provider to determine the grade of your cancer, or its potential to be aggressive.

Staging prostate cancer

Cancer staging allows your provider to determine how advanced your cancer is, or how much it’s spread. Cancer may be in your prostate gland only (local), invading nearby structures (regional) or spread to other organs (metastasized). Prostate cancer most commonly spreads to your bones and lymph nodes. It can also develop in your liver, brain, lungs and other organs.