Essential tests

When you see the doctor

At some stage they will suggest/or you will request a PSA blood test.

Prostate Specific Antigen (PSA): A blood test that measures a substance manufactured solely by prostate gland cells. An elevated reading indicates an abnormal condition of the prostate gland, either benign or malignant. It is presently the most sensitive tumor marker for the identification and monitoring of prostate cancer.

You need to be aware that the NHS does not offer to men as it does to women a standard and regular cancer screening test, but if you request a PSA your doctor will oblige. Make sure you obtain a copy of the results, do not accept being told it is "satisfactory". PSA levels of up to 4.0 ng/mL are considered the upper limit of normal. However, up to 25% of men with prostate cancer have a number below 4.0 ng/mL.

At the same time your doctor will most likely carry out a DRE.

Digital Rectal Examination (DRE): A procedure in which the physician inserts a gloved, lubricated finger into the rectum to examine the prostate gland for signs of cancer.

What happens if my PSA is high?

If you had normal results on a digital rectal examination and your PSA is slightly high, your doctor may want to repeat the test to see if the PSA remains high. If your doctor felt something unusual during your DRE, more tests may be needed. One of these is a transcrectal ultrasound. Sound waves are used to create an image of your prostate on a screen to help detect tumors.

How is prostate cancer diagnosed?

A diagnosis of prostate cancer must be made by a biopsy, which is often done at the time of your ultrasound. During a biopsy, small pieces of prostate tissue are removed and examined under a microscope for cancer. The biopsy is done quickly and be sure it is carried out under anaesthetic, check this point with your doctor and insist upon it.

It is important to follow up with your doctor if something unusual is found on the digital rectal exam or if your PSA level is high. If your doctor has ordered more tests or suggested repeating the PSA test, keep your appointments. Don't let fear keep you from having the tests you need to detect - or help rule out - cancer. Prostate cancer is most successfully treated when found early.

Early prostate cancer may have no symptoms. It can only be found by regular prostate checkups. The PSA test, rectal exam, and ultrasound with biopsy are the best methods available today to detect prostate cancer early. Your doctor will recommend the tests you need, but you need to be aware knowledge is power and gives you confidence in playing your part in choosing the tests and possible treatments suited to you as an individual. "One form of treatment suits all does not apply".

What if I have more questions about the PSA blood test and prostate cancer?

Your medical practitioner should provide satisfactory answers to all your queries and assist you in obtaining second opinion should you so wish. The Prospect Helpline is also available to help with your questions.