Diagnosing Prostate Cancer


Your doctor can detect prostate cancer even if you do not have symptoms. That’s why it’s so important to have regular physical exams. Early detection means your prostate cancer can be treated sooner.


PSA is the abbreviation for prostate-specific antigen, a substance produced by the prostate cells. A PSA test measures the level of PSA in the bloodstream. 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.6,9

High levels of PSA may be a sign of prostate cancer or a noncancerous condition called benign prostatic hyperplasia.5

Find PSA Screening Sites in Your Area

A key to properly diagnosing prostate cancer is having your PSA level checked. PSA stands for prostate-specific antigen, which is a protein produced by cells in your prostate. A high level of PSA in your blood can be a sign of prostate disorders, including prostate cancer.

The Prostate Conditions Education Council® (PCEC) is a nonprofit organization made up of healthcare professionals, scientists, and advocates dedicated to saving men’s lives through education about and awareness of prostate health and other men’s health issues.

The PCEC website features an online PSA screening site finder. Just type in your ZIP code to find the PSA screening sites closest to you.


As part of your physical exam, your doctor will:

  • Ask about your personal and family history. Prostate cancer seems to run in families. Having a family member with prostate cancer may increase your risk of developing this cancer.1
  • Perform a digital rectal exam (DRE) to check your prostate for hard or lumpy areas.8
  • Take a blood test to measure PSA. A PSA level of 4.0 ng/mL is considered the upper limit of normal. However, up to 25% of men with prostate cancer have a number below 4.0 ng/mL.6


If the DRE and PSA blood test results show abnormal findings, your doctor will use other tests or procedures to diagnose your condition, such as8,63:

  • Transrectal ultrasound: Using a probe inserted into the rectum to create sound waves to produce a sonogram, ultrasound allows your doctor to look closely at your prostate for abnormal areas.
  • Transrectal biopsy: A small tissue sample is removed from your prostate using a thin needle that is inserted through the rectum and into the prostate. A pathologist checks the sample for cancer cells.


If the biopsy is taken and prostate cancer is found, the tumor is graded in the medical lab. The grade indicates the difference in appearance between normal cells and cancer cells when seen through a microscope.8

Sometimes you will hear the grade referred to as the Gleason grade. A Gleason grade ranges from 1 through 5 and is based on the degree of differentiation among the cells. A Gleason grade of 1 indicates that the cancer cell clusters resemble the small, regular, evenly spaced prostate tissue, while a grade of 5 is for irregular, fused cells that have invaded surrounding tissues.10


Prostate cancers often have areas with different grades. Therefore, a grade is assigned to the two areas that make up most of the cancer. These two grades are added together to yield a Gleason score between 2 and 10. A score of 2 represents a prostate tumor uniformly composed of Gleason pattern 1 prostate cancer cells, and a score of 10 represents totally undifferentiated cancer cells within the prostate tumor.10

Grading, along with staging, can help you and your doctor make your treatment plan.6