You may have tests at a Rapid Access Prostate Clinic. These are special clinics set up to reduce waiting times for prostate cancer testing.
Prostate cancer
Diagnosis and tests
Diagnosing prostate cancer
Your family doctor (GP) will talk to you about your symptoms. They may do a digital rectal examination (DRE) or a prostate-specific antigen (PSA) blood test. Your GP will refer you to hospital if they think you need more tests.
Inserting a gloved finger into your back passage to see if your prostate feels normal. It can be a little uncomfortable but it doesn’t take long.
This test checks the level of prostate-specific antigen (PSA) in your blood. A raised PSA level can be a sign of prostate cancer, but it can also be caused by other conditions like a urinary infection or inflammation of the prostate (prostatitis).
Important to know:
- A raised PSA doesn’t always mean cancer. In fact, 2 out of 3 men with a raised PSA do not have prostate cancer.
- Some men with prostate cancer have a normal PSA level.
Before your PSA test:
- Avoid ejaculation or intense exercise for 48 hours beforehand.
- You may need to delay the test if you have a urinary infection or had a prostate biopsy in the last 6 weeks.
Talk to your GP for the best time to have the test.
This is a type of MRI scan that creates more detailed pictures of your prostate than a standard MRI. It may be done before you have a biopsy to help your doctors decide where to take samples of cells from
A prostate biopsy uses a needle to take small samples of prostate tissue. These samples are examined by a pathologist to see how abnormal the cells are. There are 2 ways to do a prostate biopsy:
Most prostate biopsies are transperineal biopsies.
- Transperineal needle biopsy
The needle goes through the skin between the testicles and the back passage (perineum). The biopsy is guided by an ultrasound probe, which is put into your back passage. - Trans-rectal ultrasound (TRUS) biopsy
An ultrasound probe is put into your back passage. It uses sound waves to produce pictures of your prostate. A biopsy can be taken through the back passage.
Read more about prostate biopsies.
A urologist is a doctor who specialises in treating prostate, bladder and kidney problems.
If you are diagnosed with prostate cancer, we're here for you.
Our cancer nurses are here if you need information or just want to talk. They can help you to understand your diagnosis and what to expect, send you information and tell you about our services.
Further tests for prostate cancer
You may need further tests to give your doctors more information about your general health and about the cancer.
A type of X-ray that gives a detailed picture of the tissues inside your body.
Read more about CT scans.
A scan that uses a radioactive injection to show up cancer cells.
Read more about PET scan.
A radioactive injection that can show areas of abnormal bone on a scan, which may be caused by cancer that has spread.
Read more about bone scans.
You may have bone X-rays if the bone scan shows up any abnormal areas. These X-rays will help to confirm if the cancer has spread or not.
A device like a microphone passed over your tummy area. It can show any abnormal changes.
Read more about ultrasound scans.
A type of PET scan, which uses a special antibody molecule and radioactivity to see if the prostate cancer has spread to the lymph nodes or other parts of the body.
The tests you have can help to:
- Stage your cancer. This means finding out the size and position of the cancer.
- Grade your cancer. Grading describes how quickly the cancer may grow and spread and how it might respond to treatment.
Some tests may be used see how you are responding to treatment.
Waiting for test results
While some results may come back quickly, others may take a few weeks. Waiting for results can be an anxious time. It may help to talk things over with your doctor or nurse or with a relative or close friend. You can also call our Support Line on 1800 200 700 or visit a Daffodil Centre to speak to a cancer nurse.
What are the grades of prostate cancer?
Grading helps your doctor understand how the prostate cancer may behave over time. It looks at how different the cancer cells are from normal cells, and how likely the cancer is to grow or spread.
A doctor called a pathologist will look at samples of your prostate cells under a microscope. These are taken during the biopsy.
The pathologist will give the cells a grade. The grade is a number from 3 to 5 which describes how normal or abnormal the cells look.
- A lower number means the cells look more like normal cells.
- A higher number means they look less like normal cells.
Staging and grading can be hard to understand, so ask your doctor and nurse for more information if you need it.
What is the Gleason score?
The Gleason score is a system used to describe the grade of prostate cancer.
If the most common grade in the sample is 3, and the second most common grade in the sample is 4, then your Gleason score will be 7 (3+4).
If only one grade is found, then this grade is added to itself. So if all the sample is only grade 3, then the Gleason score will be 6 (3+3).
- Lower grades are slower growing
- Higher grades are faster growing
Risk groups
Your doctor may describe your cancer as low, intermediate, high or very high risk, based on:
- Your Gleason score
- The stage of your cancer
- Your PSA level
The risk groups reflect the level of risk to your future health from the prostate cancer.
Prognostic grade groups
Some doctors describe prostate cancer as a prognostic grade group, using numbers 1 to 5. Grades go from grade 1, which has the best outlook, up to grade 5, which describes cancers which grow more quickly.
The prognostic grade group is worked out from the Gleason score by the pathologist.
What are the stages of prostate cancer?
Staging means finding out how big the cancer is and if it has spread to other parts of your body. Staging will help your doctor to plan the best treatment for you.
TNM staging system
The staging system normally used is called TNM. This stands for:
T1: The tumour is within your prostate gland. It is too small to be felt during a rectal exam.
T2: The tumour is still within your prostate gland. It is large enough to be felt during a rectal exam.
T3: The tumour can be felt throughout your prostate, and may have broken through the outer layer of the prostate.
T4: The tumour has spread to organs outside your prostate gland.
N: Cancer is present in the lymph nodes
N0: No cancer in the lymph nodes
N1: Cancer has spread to 1 or more of the lymph nodes
If you have been diagnosed with early prostate cancer you will see N0, meaning the cancer has not spread out of the prostate.
M: The cancer has spread to lymph nodes and/or other organs, commonly bones.
M0: The cancer has not spread
If you have been diagnosed with early prostate cancer you will see M0, as the cancer has not spread outside the prostate
Staging and grading can be hard to understand, so ask your doctor and nurse for more information if you need it so you can find the best treatment for you. You can also call our Support Line nurses on 1800 200 700.
Continue reading about prostate cancer
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