Metastatic prostate cancer

Prostate specific antigen (PSA) is a protein that can be detected in your blood. It can rise due to disease in your prostate gland. A sample is taken from your blood and measured. A PSA test can also show how your cancer is responding to treatment. 

A biopsy is where a sample of your prostate tissue is taken and
examined under a microscope. You may not need a biopsy.

Metastatic prostate cancer often spreads to the bones. Bone scans can find cancer spots before they show up on an ordinary X-ray. For this test, a tiny amount of a radioactive liquid is put into one of your veins, usually in your arm.

After the injection, you must wait for up to 3 hours. It’s nice to have someone with you to keep you company if you’re having this test, as it takes a while and involves a bit of waiting around. After the waiting period, a scan is taken of all the bones in your body. Abnormal bone takes up more radioactive liquid than normal bone. These areas will show up on the scan and are known as ‘hot spots’. The scan can also show bone changes like arthritis. After a bone scan you may have an X-ray, MRI or PSMA PET scan to give your doctors more information.

You may have bone X-rays if the bone scan shows up ‘hot spots’.
X-rays can check the health of your bones and if you are at risk of
bone fractures. A chest X-ray may be done to check your general
health.

This is a special type of X-ray that builds up a detailed picture of the tissues around your chest, abdomen and pelvis. The scan is painless and takes 10-30 minutes.

Read more about CT scans.

This scan uses magnetic energy to build up a picture of the tissues inside your body. During the scan you will lie inside a machine. Read more about MRI scans.

A PET scan uses a low dose of radioactive sugar to measure the activity in your cells. It is also used to diagnose or determine the stage of a number of different cancers. 

Read more about PET scans.

This test uses a radioactive dye to show up certain areas of the body. PSMA-PET or CT scans look for areas of the body where the PSMA protein is found. The PSMA protein is found on prostate cancer cells and can show the presence of prostate cancer cells with greater accuracy than CT and bone scans. Not every patient with prostate cancer will need a PSMA scan, but they may be used in certain situations. For example, they are often used when there is
biochemical recurrence. This is when your PSA level starts to rise again after treatment.

Read more about cancer tests.