How Is Prostate Cancer Diagnosed?

The results of a patient’s digital rectal examination (DRE) or prostate-specific antigen (PSA) help define a prostate cancer diagnosis.

Prostate cancer can often be detected early through screening tests. Advanced cancer, however, is sometimes not found until symptoms have begun presenting. When a physician suspects the presence of prostate cancer, testing will need to be performed to confirm or rule out the diagnosis.

Medical history and physical exam

Upon suspicion of prostate cancer, your doctor will ask necessary questions regarding your medical history, as well as conduct a physical exam. You may be asked about symptoms, risk factors and family history details. The physical exam typically includes a digital rectal examination (DRE), during which the doctor will manually feel for any bumps or hard spots on the prostate.

What tests are used to diagnose prostate cancer?

If a physician suspects a prostate cancer diagnosis based on the results of a patient’s DRE or prostate-specific antigen (PSA) test, the two main tests that are used to detect prostate cancer, he or she will typically order a series of additional diagnostic tests. These exams may include:

  • An ultrasound, in which a small probe is inserted into the rectum and uses sound waves to create an image of the prostate gland
  • A prostate biopsy, in which a small needle is inserted into the prostate gland to obtain 12 to 14 tissue samples for further evaluation under a microscope
  • Bone scans, CT scans, MRIs and/or PET scans, which can provide additional images to determine if the cancer has spread beyond the prostate

If cancer is present, another laboratory assessment is usually completed before the patient is given a final prostate cancer diagnosis. A pathologist will look at the various characteristics of the cancer and assign it a Gleason score, or a “grade,” to indicate its chances of spreading (metastasizing). The higher the Gleason score, the more aggressive the cancer, and the more likely it is to metastasize.

At Moffitt Cancer Center, we offer a range of care for prostate cancer including for men who already had a PSA elevation finding or abnormal DRE or both and want to discuss next steps. Our Genitourinary Oncology Program is always accepting new patients – whether those patients are looking for an initial diagnosis, a second opinion, or a comprehensive treatment plan. We have an experienced team of oncologists who specialize in treating prostate cancer, and we don’t require a referral to make an appointment.

Medically reviewed by Monica Chatwal, MD.

To arrange a visit to Moffitt’s Genitourinary Oncology Clinic, call 1-888-663-3488 or request an appointment. We will schedule a time for you to discuss your potential or existing prostate cancer diagnosis with one of our skilled oncologists.