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Your GP will ask you questions about your symptoms and look at your medical history to see what illnesses you have had in the past.
S/he may also...
- carry out a digital rectal examination (DRE)
The doctor places a gloved finger in the rectum to feel the prostate gland. S/he will note whether it is enlarged, and what it feels like. A cancerous prostate tends to feel harder than a non-cancerous one. - take a blood sample (PSA test)
This is to check for a substance called prostate-specific antigen (PSA).
A high level of PSA may be a sign of cancer, but the test is not foolproof. The older you are, the higher your PSA level is likely to be whether or not you have cancer. Your doctor will decide whether your PSA is higher than normal for your age, using an age-specific PSA guide. Also, some non-cancerous conditions can raise your PSA... and around one in ten prostate cancer patients have a normal PSA level.
If your GP thinks you may have cancer s/he will send you to see a specialist doctor (a urologist). There are cancer referral guidelines to help GPs decide who may need to see a specialist, and how quickly.
At Noble's Hospital you may have these tests:
Transrectal ultrasound
Your doctor will need to take some samples of tissue (biopsies) to be examined under a microscope.
S/he uses a fine needle to take the samples from the prostate. First, an ultrasound probe with a needle inside it is put into the rectum. The probe makes a picture on a computer screen, which the doctor uses to guide the needle to exactly the right place. You will usually be given a local anasthetic, and gas and air, to reduce any discomfort. Most men say this test is unpleasant, but normally it isn’t too painful.
A doctor in the laboratory will look at your cells to see whether you have cancer. If you do, the cancer will be given a Gleason score of between Gl 2 and Gl 10.
The Gleason score tells your doctor how aggressive the cancer is – in other words, how fast it might grow, and how much it might spread. The lower the score the better – but remember, no one can know for sure how your cancer will behave.
Repeat PSA blood test
The hospital doctor will check your PSA level again.
You may also need to have an MRI scan or CT scan and possibly a bone scan as well to see if there are any signs of the cancer spreading.
Magnetic resonance imaging (MR or MRI scan)
The MRI scan uses a magnet and radio waves to create a picture of the inside of the body. You lie on a couch inside a long chamber while the pictures are taken. The scan helps the doctor to see how far the cancer has spread.
Bone scan
This is a test to look for any areas of bone where there is a lot of activity.
The activity could be bone breaking down, or bone repairing itself. There are several possible reasons for bone activity - cancer is one of them, but other reasons include arthritis, fractures and bone infections, so the test results need to be carefully interpreted.
