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Prostate cancer diagnostic evaluations

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Our prostate cancer experts use a variety of diagnostic tools and technologies, including imaging and laboratory tests, to screen for the disease. Knowing that waiting for answers can add to your anxiety, we offer reduce wait times for appointments, while working to deliver results in an expedited manner. Our multidisciplinary team of doctors and clinicians will then use what they learn to evaluate the type, stage and extent of the disease, so we can develop a treatment plan personalized to your needs, goals and preferences.

The types of tests you may undergo to diagnose prostate cancer include those listed below.


During a prostate cancer biopsy, your doctor guides a small probe into the rectum and removes a small tissue sample from the prostate for further examination. This tissue allows the doctor to stage the disease and determine an appropriate treatment plan.

Digital rectal exam

A digital rectal exam is usually the first step in determining prostate health, and is often performed as part of routine screening, such as an annual physical.

Imaging tests

A number of imaging tests may be used to determine the type, stage and progression of your prostate cancer, including:

Bone scan: Prostate cancer may metastasize to the bones. If you are experiencing bone pain or blood tests reveal elevated calcium levels, your radiation oncologist may perform a bone scan to detect if prostate cancer has spread to the bones.

CT scan: A CT scan reveals blood flow and anatomy of tissues in and around the prostate, allowing for the diagnosis and monitoring of tumor growth.

MRI: Magnetic Resonance Imaging (MRI) may be especially useful for the prostate, due to greater soft tissue contrast.

PET/CT scan: A PET/CT scan is useful for prostate cancer because scans may reveal cancerous cells before tumors or structural changes are present. This is important to catch the disease early. We may use the GE Discovery™ PET/CT 600 scanner,a four-dimensional CT scanner that produces detailed cross-sectional X-ray images of structures within the body. It also enables radiologists to plan treatment in accordance with patients’ breathing patterns.

ProstaScint scan: This technology may be used to determine whether prostate cancer has spread to the lymph nodes, adjacent tissues or bones.

Ultrasound: This technology may be used to monitor prostate size, tumor response or activity in other tissues. In detecting prostate cancer, your doctor may also recommend a transrectal ultrasound. During this exam, a small probe is inserted into the rectum so sound waves may provide a picture of the prostate and measure its size. Images will reveal tumors, calcifications and enlargement of the prostate.

Advanced genomic testing

The most common lab test for prostate cancer is advanced genomic testing, which examines a tumor to look for DNA alterations that are driving the growth of cancer. By identifying the mutations that occur in a cancer cell’s genome, we are able to see a clearer picture of tumor behavior, and may be able to tailor your treatment based on these findings.

PSA test

Prostate specific antigen (PSA) is a protein found in prostate cells that helps to keep semen liquified. Most cases of prostate cancer develop in these cells, so an elevated PSA count may be a sign of prostate cancer.

For most men, a PSA level of 4 nanograms per milliliter (ng/ml) of blood is normal, according to the American Cancer Society. Doctors may set a baseline PSA level lower for men with higher risk, such as African Americans and those with a family history of prostate cancer.

Not all men with high PSA levels have prostate cancer. High levels may also be caused by a urinary tract infection, prostatitis or benign prostatic hyperplasia, all of which are noncancerous conditions. But, according to the American Cancer Society (ACS):

  • Men with a PSA level between 4 and 10 have a 25 percent cancer of having prostate cancer.
  • Men with a PSA level more than 10 have a 50 percent chance of having prostate cancer.

Men with a low PSA level may still develop prostate cancer. PSA tests are not an indication of how aggressive the prostate cancer may be. Many prostate cancers are slow growing and do not require immediate treatment.

PSA can be measured with a blood test that often is performed along with a digital rectal exam (DRE), which allows your doctor to feel the prostate for abnormalities in shape, size and texture. According to the ACS, healthy men with a low or average risk of developing prostate cancer should talk to their doctor about screening at the age of 50. Men with a higher risk should talk to their doctor about screening at 40 or 45.

National Comprehensive Cancer Network suggests theses screening guidelines and recommendations for men older than 45.

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 Age   PSA level 
 DRE   Recommendation
45-75 Less than 1 Normal Get re-screened every two to four years
45-75 1 to 3 Normal Get re-screened every one to two years
75 or older Less than 3 Normal Get re-screened every one to four years
45 or older More than 3 Suspicious Consider a biopsy or additional testing

Learn more about the symptoms of prostate cancer

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