Prostate cancer is typically diagnosed through a combination of medical history, physical examination, imaging tests, and a blood test to measure prostate-specific antigen (PSA) levels. The diagnostic process may include the following steps:
Medical History and Physical Examination: Your doctor will review your medical history, ask about any symptoms you might be experiencing, and conduct a physical examination, including a digital rectal examination (DRE). During the DRE, the doctor will insert a gloved, lubricated finger into the rectum to feel the prostate gland and check for any abnormalities.
PSA Blood Test: A PSA blood test measures the level of PSA, a protein produced by the prostate gland, in the blood. Elevated PSA levels can indicate various prostate conditions, including prostate cancer. However, PSA levels can also be elevated due to non-cancerous conditions like benign prostatic hyperplasia (BPH) or prostatitis.
Biopsy: If the PSA level is elevated or if there are other suspicious findings, your doctor may recommend a prostate biopsy. During this procedure, small tissue samples are taken from the prostate gland using a needle guided by ultrasound. A pathologist then examines the tissue samples under a microscope to determine if cancer cells are present.
Imaging Tests: Imaging tests like ultrasound, MRI (magnetic resonance imaging), or CT (computed tomography) scans may be used to further evaluate the prostate and surrounding tissues and assess the extent of the cancer if it's detected.
Gleason Score: If prostate cancer is confirmed through the biopsy, the pathologist will assign a Gleason score, a grading system that helps determine the aggressiveness and potential spread of the cancer.
As for PSA levels, what is considered "normal" can vary based on factors such as age, race, and individual health. Generally, PSA levels tend to increase with age. However, the American Urological Association (AUA) provides some general guidelines:
- For men aged 40-49: A PSA level of 0-2.5 ng/mL is considered normal.
- For men aged 50-59: A PSA level of 0-3.5 ng/mL is considered normal.
- For men aged 60-69: A PSA level of 0-4.5 ng/mL is considered normal.
- For men aged 70 and older: A PSA level of 0-6.5 ng/mL is considered normal.
It's essential to remember that a single PSA test result does not definitively diagnose prostate cancer. Instead, it provides information that, when considered alongside other factors like medical history, physical examination, and imaging, can help guide further evaluation and decisions about potential biopsies or other diagnostic tests. Interpretation of PSA levels and the need for further investigation should be discussed with a qualified healthcare professional.