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Diagnosing Prostate Cancer

The best way to diagnose prostate cancer is through screening performed as part of an annual physical examination. Screening involves an annual digital rectal exam (DRE) and a prostate specific antigen (PSA) blood test.

Digital Rectal Exam (DRE)

The digital rectal examination can detect cancer and judge whether it is confined to the prostate. Because it lies in front of the rectum, the doctor can feel the prostate by inserting a gloved, lubricated finger into the rectum. The digital rectal exam is not always accurate as many prostate cancers are situated deeper in the gland or are too small for detection.

Prostate Specific Antigen (PSA) Blood Test

Prostate-specific antigen (PSA) is a protein produced by both normal and cancerous prostate cells. When prostate cancer grows or when other prostate diseases are present, the amount of PSA in the blood often increases.

  • A PSA test is generally said to be in the normal range when it is reported to be between 0 and 4 nanograms per milliliter, sometimes abbreviated as ng/mL on the lab report.
  • If the results are in the high range (or have increased since a prior test), your physician will suggest a biopsy, which is the only test to actually diagnose prostate cancer.

Percent-Free PSA Ratio

Percent-free PSA ratio is a blood test that measures how much PSA circulates by itself (unbound) in the blood and how much is bound together with other blood proteins. If PSA results are borderline and percent-free PSA ratio is low (25 percent or less), then prostate cancer is more likely to be present. If this is the case, a biopsy may be needed.

More Information About Prostate Cancer Screening

Exams Used to Determine If Cancer Has Spread

Low Blow: One Man's Battle With Prostate Cancer writer Mike Stuckey chronicles his journey, from diagnosis through treatment. Click below to read about his diagnosis.