Going to the GP

If you are worried that you have symptoms or signs of prostate cancer it is vital that you visit your GP.

What tests might the GP do?

Your GP can test for prostate cancer with a rectal examination or a blood test called a Prostate Specific Antigen (PSA) test. However, it can only be confirmed by examining prostate tissue (a biopsy) under a microscope, though often CT and MRI scans will be used to give further details, sometimes prior to and sometimes after the biopsy. These help to tell the difference between early and late prostate cancer. Advanced prostate cancer can sometimes be diagnosed when men visit the doctor feeling unwell, with tiredness, loss of appetite and perhaps bone pain. A bone scan can sometimes be used to see if the prostate cancer has spread into the bones.

Digital Rectal Examination (DRE)

You will be asked to lie on a couch on your side with your knees drawn up towards your chin. The doctor or specialist nurse will then put a gloved finger up into your bottom. He or she will be able to feel your prostate through the rectum wall. The aim is to discover whether the prostate feels normal, or whether there are areas that are hard, lumpy or in some way abnormal. Again, this is not an accurate way to diagnose prostate cancer, especially given that an enlarged prostate is both a natural part of the aging process as well as a symptom of BPH. It is a first test to find out if further testing is needed.

DRE for prostate diagnosis. www.pcr.org.uk

PSA test. www.pcr.org.uk

Prostate Specific Antigen (PSA) Test

PSA is made by your prostate and some of it leaks into the blood. A small sample of blood is taken from a vein in your arm and sent to a laboratory to measure the level of PSA. About 50% of men with prostate cancer at the time of diagnosis have a raised PSA (above 4 micrograms per litre or nanograms per millilitre). But only one in four men with a PSA level between 4 and 10 micrograms per litre have prostate cancer. There are various reasons for a raised PSA level. A high PSA does not necessarily mean you have cancer nor does a lower level mean you do not. It is generally felt that the PSA test is not accurate enough to be used to screen every man.

Bone Scan

During this simple procedure, a tiny, harmless amount of radioactive substance is injected into your veins and taken up by abnormal bone. The injection is given in the morning and the images are taken about 4 hours later. Any spread of cancer to the bones shows up as dark areas.

Magnetic Resonance Imaging (MRI) Scan

An MRI machine scans your prostate looking for abnormal areas. If prostate cancer is detected it will help determine how much cancer is present. In many centres MRI is done prior to prostate biopsies, often centres do MRI scans after prostate biopsies and after the cancer is detected. The MRI machine is a large cylinder surrounded by a magnet. You will lie on a moveable table which will slide into the MRI machine for the picture of your prostate to be taken. The procedure is quick, usually about half an hour or so, and completely painless, but it can be extremely effective in helping to uncover what the best type of treatment is, depending on how much cancerous tissue is detected.

Trans-Rectal Ultrasound and Biopsy (TRUS)

You will be asked to lie on your side with your knees drawn up towards your chin (the same as for a digital rectal examination). An ultrasound probe is inserted in your back passage. A needle is used to take samples (biopsies) from your prostate, and these are sent for examination under a microscope to look for prostate cancer. Usually twelve or more biopsies are taken. Often you will have a local anaesthetic to make the procedure more comfortable. Another method of obtaining prostate samples is through the perineum. This is called transperineal biopsy. It is usually done under sedation or general anaesthetic.

If prostate cancer is diagnosed, it will be at one of three stages. You can read more about each stage below and the different treatments.

Press enter or esc to cancel