Procedures used to evaluate prostate problems

In addition to an annual physical examination that includes blood, urine, and possibly other laboratory tests, the National Cancer Institute and the American Cancer Society suggest consulting your physician about these recommendations for the evaluation of the prostate gland:

• DRE (digital rectal examination)

  A physician or nurse places a gloved and lubricated finger into the rectum to examine the rectum and feel the prostate gland. As recommended by your physician, DREs are usually conducted annually for men over the age of 50. Men in high-risk groups, such as African-Americans, or those with a strong family history of prostate cancer, should consult their physicians about being tested at a younger age or more often.

• PSA (prostate-specific antigen)

  PSA is a blood test that measures the level of prostate specific antigen. PSA is a substance produced by the prostate gland, which may be found in higher amounts in men who have prostate cancer. As recommended by your physician, the PSA test is usually done annually for men over the age of 50. Men in high-risk groups, such as African-Americans, or those with a strong family history of prostate cancer, should consult their physicians about being tested at a younger age or more often.

What are some other prostate cancer evaluation procedures?

If the results of the DRE or PSA are unusual, your physician may repeat the tests or request other procedures. These evaluation tools may include:

• transrectal ultrasound (TRUS)

  a test using sound wave echoes to create an image of the prostate gland to visually inspect for abnormal conditions. A transrectal ultrasound can show if the prostate gland is enlarged or if there are any growths in or around the prostate. Ultrasound may also be used to guide a needle for biopsies of the prostate gland and/or to guide the nitrogen probes in cryosurgery.

• computed tomography scan (Also called a CT or CAT scan.)

  a diagnostic imaging procedure test that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than standard x-rays.

• magnetic resonance imaging (MRI)

  a diagnostic test that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

• radionuclide bone scan

  a nuclear imaging method that helps to show whether the cancer has spread from the prostate gland to the bones. The test involves injecting a radioactive material into a vein that helps to locate diseased bone cells throughout the entire body.

• (lymph node and/or prostate) biopsy

  a procedure in which tissue samples are removed (with a needle or during surgery) from the body for examination under a microscope; to determine if cancer or other abnormal cells are present.

The diagnosis of cancer is confirmed only by a biopsy.