Prostate cancer diagnosis typically involves several steps and tests to accurately identify the presence and extent of cancer. Here's a general outline of the diagnostic process:
- Medical History and Physical Examination: The process begins with a provider evaluating the patient's medical history, symptoms, family history of prostate cancer, and other health factors. A physical examination, including a digital rectal examination (DRE), allows the doctor to feel for any irregularities on the prostate.
- Prostate-Specific Antigen (PSA) Test: This blood test measures the level of PSA, a protein produced by the prostate gland. Elevated levels can indicate prostate cancer, but they can also be caused by other conditions like prostatitis or benign prostatic hyperplasia (BPH).
- Blood and urine-based biomarker tests, such as 4K score and ExoDX Prostate IntelliScore to more accurately predict the risk of having clinically significant prostate cancer in the setting of an elevated PSA test.Imaging Tests: Imaging techniques such as ultrasound (specifically a transrectal ultrasound), MRI, or CT scans may be used to visualize the prostate and detect any abnormalities.
- Biopsy: A biopsy is typically performed to confirm the diagnosis if other tests suggest cancer. During a biopsy, small samples of prostate tissue are removed with a needle, usually guided by ultrasound, and examined under a microscope for cancer cells. Transperineal biopsy has been shown to offer improved diagnosis and lower risks.
- Gleason Score and Grade Group: If cancer is confirmed, the biopsy samples are analyzed to determine the aggressiveness of the cancer cells. The Gleason Score and the newer Grade Group help assess the likelihood of the cancer growing and metastasizing (spreading).
- Additional Tests: For some patients, additional tests might be needed to determine if the cancer has spread beyond the prostate. These tests can include bone scans, PET scans, or additional MRIs.
Each step helps provide a comprehensive overview of the patient's condition and guides the treatment plan. Individuals experiencing prostate cancer symptoms can obtain a prompt and accurate diagnosis from the GW Cancer Center Urological Oncology Program’s multidisciplinary team of medical and radiation oncologists, surgeons, pathologists, and advanced practice providers.
