Prostate Cancer Screening

Men whose cancer is confined to the prostate rarely have any symptoms. Screening tests for prostate cancer can include:

• Digital rectal exam (DRE) - Part of a regular medical checkup. In this quick test, the doctor inserts a gloved finger (a “digit”) into the rectum to check the size of the prostate and determine whether any parts of it are lumpy or abnormal.
• Prostate-specific antigen (PSA) test - A blood test to check your levels of a protein produced by the prostate gland. However, your PSA level also depends on your age, ethnicity, medical history, and other factors, so an elevated PSA level doesn’t usually mean you have cancer. In fact, two-thirds of the time, a high PSA level has nothing to do with cancer — and some prostate cancers don’t cause an increase in PSA at all. For men at high risk of developing prostate cancer, however, a PSA test can sometimes be useful in combination with other methods of cancer detection. For example, if your PSA levels are higher than usual and a digital rectal exam or MRI suggests that something is abnormal, your doctor is likely to recommend a biopsy. Getting a PSA test is a personal decision that should weigh the potential benefits as well as the downsides. To help minimize overdiagnosis and overtreatment while reducing the chances of undertreating aggressive prostate cancer, Fox Chase doctors are harnessing some of the latest tools including new biological indicators, tissue genetic profiling, new imaging technology, and novel biopsy techniques to appropriately respond to this condition.

If initial screening techniques suggest that a further assessment is warranted, then the next step is a biopsy, in which your doctor will remove very small samples of prostate tissue for analysis. This is not a major procedure and can be done as an outpatient usually with a local anesthetic in the doctor’s office. The doctor typically takes 12 samples (or “cores”) from different parts of the prostate, and the whole process takes about 10 minutes. It is normal to find some blood in the urine, stool, or semen in the week or so following the biopsy. While infections aren’t common, you will receive antibiotics before the procedure takes place to reduce any risk.