About this page. This is a plain English summary of how prostate cancer is diagnosed. It does not replace medical advice from your own doctor or specialist.
For full information and references, please read the detailed page.
Why diagnosis matters
Prostate cancer is one of the most common cancers in Australian men. Some prostate cancers grow slowly and may never cause harm. Others can grow quickly and need treatment. The job of diagnosis is to work out which type a person has, so the right plan can be made for them.
The main tests
PSA blood test
PSA is short for prostate-specific antigen. It is a protein made by the prostate. A blood test measures how much PSA is in your blood.
A higher PSA can be a sign that the prostate needs checking. But a high PSA does not always mean cancer. Other things, such as an enlarged prostate or a urinary infection, can also raise PSA.
Digital rectal exam (DRE)
The doctor gently feels the prostate through the back passage to check its size, shape, and feel. This takes only a few seconds.
Multiparametric MRI
A multiparametric MRI is a detailed scan of the prostate. It can show areas that look unusual and help the doctor decide if a biopsy is needed, and if so, where to take samples from.
Biopsy
If the tests above suggest a problem, a biopsy may be done. A biopsy means taking small samples of the prostate so they can be looked at under a microscope.
At Urology NSW, the preferred method is a transperineal biopsy. The needle goes through the skin between the scrotum and the back passage. This route has a very low risk of infection compared with the older method that goes through the bowel wall.
What the results tell you
The biopsy result will say whether cancer was found. If it was, it will also describe how aggressive it looks (the grade) and where it was found in the prostate.
Other tests, like CT or bone scans, may then be used to see whether the cancer has spread. This is called staging.
Talking through the results
Hearing about a possible cancer can be very stressful. Dr Kooner usually spends time over more than one appointment to go through the results, what they mean, and what the choices are. You are welcome to bring family or a support person.
Important things to know
- No single test can prove or rule out prostate cancer on its own. Doctors look at the whole picture.
- Each test has possible downsides. PSA can be falsely high or falsely low. MRI sometimes misses small cancers. Biopsies have a small risk of bleeding or infection.
- Whether to have testing at all is a personal choice. It should be discussed with a qualified health professional who knows your history.
What you can do next
- Read the full detailed page for full information and references.
- Short version overview of prostate cancer.
- Short version summary of treatment options.
- Request a second opinion if you have already had tests done.
- Call 02 8382 6980 to make an appointment.