Prior to subjecting the patient to diagnostic procedures, the physician normally inquires about the patient’s history of medical conditions, his family history of cancer, and the symptoms that are causing the problem-especially the problems in urination that so often characterize prostate cancer. Then the doctor recommends the specific tests to confirm prostate cancer diagnosis. Possible tests recommended for diagnosis include the DRE, PSA, TRUS, and biopsy.
The DRE, short for Digital Rectal Exam, is a simple physical test made by the doctor who feels the size of the patient’s prostate gland, which is located just in front of the rectum. The physician properly lubricates a gloved finger and inserts it into the rectum to feel the size and structure of the prostate. If an enlargement or presence of lumps or other abnormalities are felt, the patient is subject to further testing.
PSA stands for Prostate Specific Antigen, a protein manufactured naturally by the cells of the prostate gland. The PSA test measures the level of PSA in the patient’s blood in terms of nanograms per milliliter (ng/mL). In men, who are not affected with prostate cancer, the PSA level is usually lower than 4 ng/mL. Above this level, PSA in blood indicates prostate cancer. In some cases, doctors suspect prostate cancer risk even for PSA levels that are above 4 ng/mL, especially in elderly patients. However, PSA test alone is not enough to confirm prostate cancer diagnosis and the patient is subject to further testing.
Transrectal Ultrasound, or TRUS, also known as prostate ultrasound, is a technique that gets an image of the prostate gland by means of sound waves. Prior to taking TRUS, the patients are instructed to drink plenty of water (to fill the bladder for a better view) and/or take enema in order to cleanse the bowels. A small transducer is inserted in the patient’s rectum for directing high-frequency sound waves into the body. In case, the TRUS image indicates enlargement or abnormality of the prostate gland, biopsy is recommended to confirm prostate cancer diagnosis.
Biopsy involves taking out a sample of the patient’s prostate tissue and examining it under a microscope to detect the presence of cancerous cells. To date, biopsy is the surest test to confirm prostate cancer diagnosis. More than one tissue is required from different parts of the prostate so as not to miss the cancerous area, if it exists. Even the negative result of multiple tissue examination does not entirely rule out the possibility of prostate cancer.
Most recently, scientists have launched the first ever molecular urine test that serves to confirm prostate cancer diagnosis. Known as the PROGENSA™ PCA3, this test will be done prior to biopsy and the result of the test will help doctors decide whether or not the biopsy is required. PCA3 stands for Prostate Cancer Gene 3 is a genetic marker for prostate cancer in men; its presence predicts the presence of prostate cancer. Biopsies are known to be quite a painful procedure for most prostate cancer patients and the arrival of PROGENSA™ PCA3 test is expected to confirm prostate cancer diagnosis more quickly and more painlessly.