How Does My Doctor Know I Have Prostate Cancer?

If you're having symptoms that might indicate a problem with your prostate, such as having trouble urinating, your doctor will want to know why. Your doctor is likely to ask you questions about your:

• Medical history

• Family history of cancer

• Lifestyle habits, such as what you eat and how much you exercise

• Exposure to other risk factors

In addition to asking you questions, your doctor may also perform a physical exam. Here's what your doctor may do to evaluate you:

• Give you a digital rectal exam (DRE). During a DRE, the doctor or nurse practitioner inserts a gloved, lubricated finger into the rectum. The prostate can be felt through the rectal wall. The examiner will check for hard or lumpy areas. Lumps in the prostate are called nodules.

• Use blood tests to measure your levels of prostate-specific antigen (PSA). You'll give a small sample of your blood to be checked in a lab. Your doctor will get measurements of your blood levels of PSA, and possibly prostatic acid phosphatase (PAP) as well. PSA levels may rise in men who have prostate cancer; benign prostatic hyperplasia, a noncancerous growth of the prostate; or an infection in the prostate. PAP levels may also rise in men with prostate cancer.

• Use urine tests to look for blood or infection. A sample of your urine will be sent to a lab for evaluation.

• Use tests to help evaluate your urinary problems, looking for blockages or other problems. These tests may include looking into the urethra and bladder with a cystoscope in a process known as cystoscopy. Or your doctor may recommend an X-ray of the entire urinary tract called an intravenous pyelogram.

The results of these tests may be enough to rule out cancer. Or the results may require more tests. If your PSA level is only a little high, but your DRE was normal, your doctor may recommend having another PSA test in the near future. If it's still not normal, then your doctor may recommend other tests, such as a prostate biopsy.

To tell for sure if you have prostate cancer, your doctor will need to remove tissue from your prostate. This is called a biopsy.

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