Diagnosis

Your local or family doctor can test for prostate cancer with a blood test and a rectal (back passage) examination.

In a rectal examination, the doctor inserts a gloved finger into the rectum to feel the prostate gland to check for anything unusual.

The blood test checks your prostate-specific antigen (PSA) level. The higher your PSA level, the higher the likelihood is of you having prostate cancer.

When prostate cancer is treated, the PSA level will decrease. During the course of treatment, your PSA level will be checked occasionally to see how the treatment is progressing.

Following your initial check-up, your doctor may refer you to a hospital for further tests. You may not need to undergo all of the following examinations. Your doctor will discuss the details with you.

  • Trans-rectal ultrasound scan and biopsy

    An ultrasound probe called a trans-rectal ultrasound is passed into the rectum. The probe is the size of the thumb. It shows the shape and texture of the prostate on a screen. The ultrasound picture helps guide a small needle from the probe through the rectum into the prostate. Some samples of prostate tissue are taken from different parts of the prostate and checked under a microscope for signs of cancer.

    The examination may be uncomfortable and there may be some bleeding, but it should take only a few minutes

  • X-ray

    Your chest and pelvic area may be X-rayed to check if any cancer cells have spread to other parts of your body.

  • Isotope bone scan

    A bone scan is highly sensitive and allows to cancer cells to be detected earlier than with X-rays.

    A small amount of radioactive material (technetium) is injected into a vein, usually in your arm. This material is attracted to areas of bone where cancer cells are present.

    After the injection, you will have to wait three hours before having the scan. Any area where cancer cells exist will be shown on a screen.

    You may consider taking a book to read or listening to music while you wait for the scan. A low dose of radioactive material is used. It will not make you radioactive or have any negative effects on your family or friends.

  • CT scan

    If the biopsy shows that you have prostate cancer you may have a blood test, bone scan, CT scan or MRI. You could have one of these tests, or a combination.

    The tests will estimate the extent of the cancer in your body and find out whether it has spread to other parts of the body. This process is known as staging. Staging helps your doctor recommend the best treatment for you.

  • MRI scan

    A magnetic resonance imaging (MRI) scan is similar to a CT scan. However, MRI scans use a magnetic field rather than X-rays to produce a cross-section of your body. Sometimes, a special dye is injected as part of the process to give a clear image.

    To have the scan, you will need to lie inside a metal cylinder – a large magnet – that is open at both ends, for about 30 minutes. If you feel uncomfortable being in an enclosed environment, tell your doctor beforehand. The MRI machine makes a loud noise when operating and you will be given ear plugs during the test. The metal cylinder has a strong magnetic field. You will therefore need to remove all metal objects before entering the room. If you have a heart rate monitor, a cardiac pacemaker or an implanted surgery clip implanted, an MRI scan is not suitable for you.

    It may take a few days for the CT scan and MRI scan results to become available. Some people may worry during this period. Sharing your feelings with family members or friends may help ease your concerns.

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