This page is about tests for prostate cancer. There are
several tests used to diagnose prostate cancer.
Blood test
Your doctor takes a sample of your blood to check for 'PSA'
(prostate specific antigen). PSA is a protein produced by
both normal and cancerous prostate cells. A high level of
PSA can be a sign of cancer but your PSA level can also be
raised in prostate conditions that are not cancer (are
benign) or if you have an infection. Your doctor may want
to rule out a urine infection before carrying out a test.
If you've had a urine infection, you shouldn't have a PSA
test for at least a month after your treatment finishes.
There is no one PSA reading that is considered 'normal'. The
reading will vary from man to man and the normal level
increases with age. But the following values are a rough
guide
- 3 or less is considered to be in the normal range
for a man under 60 years old
- 4 or less is normal for a man aged 60-69
- 5 or less is normal if you are aged over 70.
A reading higher than these values, but less than 10 is
usually due to a benign enlarged prostate. A reading higher
than 10 may also just be benign prostate disease, but the
higher the level of PSA, the more likely it is to be cancer.
Occasionally a cancer may be diagnosed in a man with a
'normal' PSA reading. But generally speaking, the higher the
reading, the more likely it is to be cancer. Some men have
PSA levels in the hundreds (or even thousands) when they are
diagnosed. The higher the level of PSA at diagnosis, the
more likely the cancer is to spread quickly. There is more
about the PSA blood test in the section on
screening for prostate cancer.
PSA blood tests are also used to monitor your treatment or
decide whether you need
treatment. If your PSA is stable, it is a sign that a
cancer is not progressing. Successful treatment shrinks
cancer and so the PSA level falls. There will be fewer
prostate cancer cells producing PSA so the level in the
blood is lower.
Rectal examination
Your doctor places a gloved finger into your rectum to feel
your prostate gland and check for abnormal signs, such as a
lumpy, hard prostate. Doctors call this test a digital
rectal examination (DRE).
Needle biopsy
If a lump or hardening of your prostate is found during your
rectal examination, your specialist may take a sample of
cells (a biopsy) to examine under a microscope. You can have
a biopsy done through the skin behind your testicles (the
perineum) or while you are having a cystoscopy examination.
But it is most often done via your back passage (rectum)
using a
transrectal ultrasound scanner.
The biopsy is done in the outpatients' department. When you
arrive at the hospital, you will be met by a nurse, who
will ask you some questions and make sure you understand
what is to happen. Before the biopsy, you may have blood
taken for a repeat PSA test. You will be given antibiotics
to help stop an infection developing after the biopsy. You
can have antibiotics 3 different ways - by mouth, by
injection into a vein or directly into the rectum in a
suppository. Before you have the biopsy, you will be told
what will happen and shown the ultrasound and very fine
needle that is used to take the tissue samples (the
biopsy). The needle is attached to a firing mechanism and
the doctor will show you this and demonstrate the noise it
makes so you know what to expect.
To have the biopsy, you lie down on your left side. The
doctor puts the rectal ultrasound probe into your rectum to
examine your prostate. To get the sample of prostate
tissue, the fine needle is put along the ultrasound probe
and into the prostate. This is a little uncomfortable, and
may be painful but it does not take long. Your specialist
will inject local anaesthetic first, to numb the area and
make the procedure as painless as possible. You will feel a
slight jolt each time the needle is fired.
After the test, you have a rest and a drink. You can then
go home. It is very important to drink a lot for the next
24 hours. There will be a small amount of bleeding from the
prostate. And there is a risk of urine infection. Drinking
plenty will flush out the blood and help to stop any
infection from developing. You will see a small amount of
blood in your urine and semen after the test. This may
continue for a few weeks, but is nothing to worry about.
But you should contact your doctor if you think you are
getting an infection.
You should phone your doctor immediately or go to casualty
if you have
- Shivering or shaking
- A high temperature
- A lot of difficulty passing urine
- To pass urine very often
- A lot of blood in your urine or bowel movement
You will need antibiotics straight away if you have a urine
infection.
Cystoscopy
This is an examination of your bladder and uretha under
anaesthetic. There is more about having a
cystoscopy in the
About cancer tests section of CancerHelp UK.
If the tests suggest problems
If your GP finds anything out of the ordinary you will be
referred to hospital for
further tests.
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