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Diagnostic Tests for Prostate Cancer
Although an increasing number of men are now
diagnosed with asymptomatic prostate cancer, many men with this form of
cancer have either locally advanced cancer or distant metastasis at the
time of diagnosis. Because there are no current ways to prevent the
development of prostate cancer it is important that early detection with
tests for prostate cancer be used as a major emphasis to control this
disease. While there are tests that may give an indication that prostate
cancer is present only a biopsy can give a definitive diagnosis.
• Digital Rectal Exam (DRE) – The prostate gland is nodular and fixed if
cancer is present. While not the most favorite of exams for men it is
important to have these done on a regular basis, particularly after the
age of 40.
• Prostate-specific antigen (PSA) – Levels of PSA are used to diagnose
and stage prostate cancer, and to monitor response to treatment. Normal
levels of PSA are 10 ng/mL. Men with BPH will also have elevated PSA
levels but two-thirds of those with a PSA greater than 10 ng/mL will
have prostate cancer.
• Transrectal ultrasonography – This test is used when the digital
rectal exam is abnormal or if the PSA is elevated.
• Prostate biopsy – This test must be performed and interpreted before
the diagnosis of prostate cancer can be established. Either a needle
biopsy or a TRUS-guided biopsy is performed.
• Grade and stage – This helps determine prognosis and guide treatment
decisions. Grade, which refers to cancer cell differentiation, is
determined by a pathologist. Prostate cancer can be staged with a
variety of tests.
• Bone scan, MRI, or CT scans – These tests may be performed to
determine the presence of tumor metastasis.
Several studies have shown a positive correlation between increased
awareness of and participation in prostate cancer screening procedures.
All men should be aware of the limitations and benefits of testing for
early detection and treatment so they can make an informed decision
about their own health care needs.
The American Cancer Society recommends that the PSA and DRE prostate
cancer test should be given every year starting at the age of 50. Men at
a higher risk, such as men with a first degree relative diagnosed at a
young age or men of African descent, should begin testing at the age of
45. Men at an even higher risk, such as multiple relatives with positive
diagnosis's, should begin testing at the age of 40. | 
