The overall outlook for prostate cancer patients has dramatically improved compared to what it was years ago. The reality is that more men are living longer after diagnosis. As already mentioned, in the past 20 years, 5-year survival rates for all stages of prostate cancer combined have increased from 67% to 99%.

One of the reasons for this positive development may be that men are getting tested at an earlier age and prostate cancer is being detected at an earlier stage.

Diagnosing Prostate Cancer

Prostate cancer is diagnosed through a series of tests and exams. Before starting the testing process, your doctor may ask you questions about your medical history, your family history of cancer and any symptoms you may be having, especially problems related to urination. Then your doctor may recommend one or more of the tests described below.

According to the American Cancer Society, two of these tests, the DRE and PSA, are recommended annually for men aged 50 and older who have a life expectancy of at least 10 years, and for those over the age of 45 who are in high-risk groups (such as African-Americans or men with a family history of prostate cancer).

Digital Rectal Exam (DRE)

Because the prostate lies in front of the rectum, your doctor can feel the prostate by inserting a gloved, lubricated finger into the rectum. This simple procedure is called a digital rectal examination (DRE). It helps the doctor to determine if the prostate is enlarged, or has lumps or other types of abnormal texture.

Prostate-Specific Antigen (PSA) Test

PSA (prostate-specific antigen) is a substance produced by the prostate cells. A PSA test measures the level of PSA in the bloodstream, and is reported as nanograms per milliliter, or ng/mL. Most men who do not have prostate cancer have PSA levels under 4 ng/mL; above this level, your chances of having prostate cancer increase. However, some experts have suggested that a lower PSA level, 2.6 ng/mL, should be used when considering prostate cancer risk.

Very little PSA escapes from a healthy prostate into the bloodstream, but certain prostate conditions can cause larger amounts of PSA to leak into the blood. These conditions include benign prostatic hyperplasia (BPH) and prostate cancer.

Because prostate cancer is not the only cause for high PSA levels, doctors cannot rely on PSA testing alone to confirm prostate cancer. It is also important to know that a low PSA level does not always mean that the prostate is cancer-free. So if prostate cancer is suspected, additional evaluation may be needed whether a man's PSA level is high or low. Keep track of your PSA levels with our simple PSA Tool.

Transrectal Ultrasound (TRUS)

Transrectal ultrasound (TRUS) is used to detect abnormal prostate growth and to guide a biopsy of the abnormal prostate area. This procedure uses sound waves to create an image of the prostate.

Biopsy

With a biopsy, a sample of tissue is taken out and examined under a microscope to check for cancerous changes. Only a biopsy can definitely confirm prostate cancer.

A doctor will usually take a number of tissue samples for biopsy. Keep in mind that even if the biopsy is negative, cancer may still be present. This is because even though multiple samples are taken, biopsy can still miss some cancers.

Once prostate cancer is discovered, the tumor is graded and staged. Grading and staging will help determine what type of treatment, if any, is most appropriate.

Learn more about grading and staging of prostate cancer in the following section.