Male speaking with doctor about a prostate cancer diagnosis

In many cases, prostate cancer does not cause noticeable symptoms until the tumor reaches an advanced stage. However, early-stage prostate cancer can often be detected through routine screening tests.

What does a urologist do for prostate cancer?

A urologist is a physician who specializes in diagnosing and treating conditions that affect the urinary tract, including the kidneys, ureters, bladder and urethra, as well as conditions that affect the male reproductive system, including the prostate gland, scrotum, testicles and penis. Many men who are diagnosed with prostate cancer receive their initial diagnosis from a urologist.

What tests are used to screen for prostate cancer?

The two main screening tests for prostate cancer are:

Digital rectal examination (DRE)

When performing a DRE, a physician will insert a lubricated, gloved finger into the rectum to feel for abnormalities, such as lumps, enlargement or tenderness, in the prostate gland and surrounding tissues. A DRE is often included in a man’s routine physical examination.

Prostate-specific antigen (PSA) test

Prostate-specific antigen is a protein produced by both healthy and cancerous cells in the prostate gland. The PSA test is a relatively simple lab test that measures the level of protein-specific antigen in the blood. An elevated level could signal prostate cancer or another prostate-related condition, such as an enlarged prostate (benign prostatic hyperplasia) or inflammation of the prostate (prostatitis).

The Right Diagnosis. Right Away.

If you've received an abnormal test result that could indicate cancer, request an appointment with our Urologic Oncology team today. Moffitt's diagnostic experts will perform the tests needed to diagnose or rule out cancer so you can know for sure.

Moffitt has the highest quality imaging technology and uses the least invasive testing procedures to give you accurate results.

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If you are experiencing symptoms that might indicate prostate cancer, please talk to your primary care physician to discuss your risks and testing options.

What tests are used to diagnose prostate cancer?

Typically, a physician will follow up on an abnormal DRE or PSA test by asking about the symptoms (if any), performing a family medical history review and ordering a series of diagnostic tests, such as:

Prostate ultrasound

When performing a prostate ultrasound, a physician will insert a small ultrasound probe (transducer) into the rectum. The transducer will emit high-frequency sound waves that will bounce off the prostate gland and surrounding tissues. A computer will convert the sound waves into high-definition images, which will be displayed on a nearby monitor, allowing the physician to evaluate the size, shape and condition of the prostate.

Biopsy

There are two main types of prostate biopsies:

Transrectal ultrasound-guided biopsy

To obtain tissue samples from the prostate gland for further evaluation, a physician will insert a transducer into the rectum and create ultrasound images of the prostate on a nearby monitor. Using the images as a guide, the physician will insert a biopsy needle through the rectum and into the prostate and then withdraw 12-14 tissue samples. The samples will be sent to a laboratory for microscopic examination by a pathologist, who can identify cancerous cells.

Transperineal ultrasound-guided prostate biopsy

A transperineal ultrasound-guided prostate biopsy is similar to a transrectal ultrasound-guided biopsy with one key difference: Instead of inserting the biopsy needle through the rectum, the physician will insert it through the area between the scrotum and anus (perineum). In addition to reducing the risk of infection, this approach allows for better sampling of all parts of the prostate, including the anterior section, which can be difficult to access via a transrectal biopsy.

Lab testing

To finalize a diagnosis of prostate cancer, a pathologist will microscopically examine the cancerous cells and assign a numeric Gleason score (grade) based on the cellular characteristics. In general, the higher the Gleason score, the more aggressive the cancer, and the more likely it is to metastasize.

Follow-up imaging

After diagnosing prostate cancer, the physician may order additional imaging tests, such as computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET) and/or bone scans to determine if the cancer has spread beyond the prostate.

Frequently asked questions (FAQs) about prostate cancer diagnosis

The following FAQ-related articles provide additional information about prostate cancer diagnosis:

Benefit from world-class care at Moffitt Cancer Center

Moffitt offers a range of individualized care for men who have received an abnormal DRE and/or PSA test result. Our renowned Urologic Oncology Program welcomes new patients who are seeking an initial diagnosis, second opinion or comprehensive treatment plan. Our multispecialty team focuses exclusively on diagnosing and treating prostate cancer, and we consistently achieve outcomes that exceed national averages.

If you would like to learn more about the diagnostic process for prostate cancer, you can request an appointment with a specialist in our Urologic Oncology Program by calling 1-888-663-3488 or submitting a new patient registration form online. We do not require referrals.

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