How to Detect Prostate Cancer

If you are a man over age 50, you should talk to your doctor about your prostate health and risk factors for prostate cancer.  The information presented here is for educational purposes; it will help you understand what your doctor and other healthcare providers consider when looking at how to detect prostate cancer.

Digital rectal exam (DRE)

The digital rectal exam, or DRE, is the oldest tool for prostate cancer detection. During a DRE, a doctor or nurse inserts a finger into the rectum and feels the prostate gland for any abnormalities. During a DRE, a doctor can only feel a portion of the prostate (not the entire gland). In addition, most early stage prostate cancers can’t be felt on DRE.  Still, because it is an simple, accessible, and low-risk test, DRE remains an important prostate cancer screening tool.

Prostate specific antigen (PSA) testing

The PSA test is a simple blood test that men over 50 may want to consider.  PSA is a protein made by the prostate gland. When the prostate is injured or diseased, the gland makes more PSA, and levels of PSA in the bloodstream go up. A rise in PSA may be an early sign of prostate cancer. But there are also many non-cancerous reasons for elevated PSA levels, including benign prostatic hyperplasia (BPH), prostatitis, urinary tract infection, and groin injury. For this reason, PSA is an imperfect method for detecting prostate cancer. Men should talk to their doctors about their individual need for regular PSA testing, based on their age, health history, lifestyle, and other factors.

Biopsy

A biopsy involves taking tissue samples from the prostate to test them for the presence of cancer. It is usually recommended by a doctor if PSA tests, DRE, and other indicators, like family history, suggest that a man may have prostate cancer. Since the late 1980s, TRUS-guided biopsy has been the standard of care in the U.S. The procedure removes samples of tissue from random sections of the prostate under ultrasound guidance.

In recent years, a sophisticated new technique known as in-bore mpMRI-guided biopsy offers men a more accurate and less invasive option. As the MRI images the prostate and locates the suspicious tumor tissue, the radiologists can insert a biopsy needle directly into the tissue to sample it.  Typically only two to three targeted samples are needed versus the twelve random sample standard in TRUS-guided biopsy.

How to detect prostate cancer with mpMRI imaging

An innovative new method for detecting prostate cancer, multiparametric magnetic resonance imaging, or mpMRI, provides a detailed digital image of the entire prostate. mpMRI uses sophisticated computer software to target suspicious tumor tissue with a high degree of accuracy. It can also rule out a prostate cancer completely, making biopsy unnecessary in men who don’t need it.

The Sperling Prostate Center offers men mpMRI diagnostic imaging of the prostate. Our facility is equipped with the latest mpMRI software, a 3 Tesla (3T) magnet, and a radiologist who leads the field in prostate mpMRI.  Fill out our consultation form to get more information.