Diagnosing Prostate Cancer

The best way to diagnose prostate cancer is through screening during annual physical examinations. Screening involves:

  • A Digital Rectal Exam (DRE), where doctors examine the prostate for signs of cancer
  • Prostate Specific Antigen (PSA) Blood Test, where doctors test a patient's blood for elevated levels of the PSA antigen, a sign of prostate cancer
  • Percent-Free PSA Ratio, another blood test to detect prostate cancer.

If physicians detect signs of prostate cancer during these screenings, they may request additional tests such as:

  • Transrectal ultrasonography (TRUS): During this procedure, a probe is used to direct sounds waves onto the prostate. Virginia Mason urologists are pioneering new imaging technology for this scan, and many patients are eligible to participate in this clinical trial.
  • Biopsy: During this procedure, physicians remove small amounts of tissue to test for cancerous cells.

Prostate Cancer Staging and Grading

Our care team helps patients understand their diagnosis and answers any and all questions they may have. First, we’ll classify a patient’s cancer using the following tools:

Clinical Stages

Clinical tumor staging indicates whether or not the tumor can be felt on an exam and whether cancer may have spread to lymph nodes or other organs.

The Gleason Prostate Cancer Grading System

In addition to the stage of disease, your doctor will assign a grade to the tumor, indicating how aggressive they believe the cancer to be. Experts examine cancerous tissue under a microscope and assign a number between 1 and 5, with 5 being the most aggressive form.

Your doctor may also refer to the "ploidy status" of the prostate cancer cells, which provide additional information about how likely a cancer is to spread.

Predicting Outcomes

Our care team has a detailed process for predicting outcomes and helping patients understand their prognosis. Physicians analyze each patient’s PSA, biopsy, Gleason score, and clinical stage to help them understand the severity of their cancer in three stages: low risk, intermediate risk or high risk.

Other Exams to Determine If Cancer Has Spread

If your doctor believes your cancer has spread, they may request other tests including a computerized tomography (CT) scan, a magnetic resonance image (MRI) and/or a bone scan.

To learn more about diagnosing prostate cancer or to make an appointment, please call (206) 583-2282.