Prostate Cancer Diagnosis

The urologists at Penn Medicine understand an accurate and quick diagnosis of prostate cancer is the key to offering the best prostate cancer treatment options in a timely and efficient manner. They work with a multidisciplinary team of cancer specialists including radiologists, surgeons and pathologists to provide an accurate diagnosis and develop a treatment plan that is customized specifically for you.

Screening for Prostate Cancer

Screening tests may be used to find some types of cancer early. Some screening tests, such as colonoscopies, are standard or routine. Other screening tests may be recommended only if a person has an increased risk for cancer.

Talk to your care provider about your medical history and screening options to see which is best for you. Men who choose to get screened because of a family history of prostate cancer or men who have several risks for prostate cancer should know about three screening tests: the prostate-specific antigen test, the digital rectal exam and the MRI-ultrasound fusion biopsy. Screening is usually recommended after age 40 in African-American men and 50 in all other men.

The Prostate-Specific Antigen (PSA) Test

The prostate-specific antigen (PSA) test is a test that measures the level of PSA in the blood. PSA is made by the prostate and may be present at higher levels in the blood of men who have prostate cancer or an infection or inflammation of the prostate. 

An elevated PSA does not confirm a diagnosis of prostate cancer, but should be followed up by a physician.

The Digital Rectal Exam (DRE)

A digital rectal exam is used to check the rectum and surrounding tissue including the prostate. A physician or nurse inserts a lubricated, gloved finger into the rectum to check for abnormalities or lumps.

Currently, researchers are studying how the PSA combined with the DRE can provide more accurate screening test results. If a screening test shows a chance of prostate cancer, your physician can help determine if having follow-up tests or if active surveillance, in which the PSA levels are routinely checked again, are the best course of action. All men should discuss the risks associated with prostate cancer screening tests with their doctor.

The MRI-Ultrasound Fusion Biopsy

This new technology helps detect and distinguish different types of prostate cancer and could be a more accurate and efficient way to biopsy suspicious areas in the prostate.

First, the patient undergoes an MRI scan. A radiologist will review the images for areas that are suspicious for prostate cancer. After that, if necessary, an MRI-ultrasound fusion biopsy is performed.

During the biopsy, an ultrasound probe is inserted into the rectum. As the ultrasound probe moves around the prostate, the fusion technology combines (or fuses) both the prior MRI images with the real-time ultrasound image.This fusion of images creates a clearer picture and a more exact location of the suspicious area to biopsy. 

The appropriate patient for a fusion biopsy is one who has had a recent MRI for the indication of suspected (or to rule out) prostate cancer. When the urologist and radiologist review the MRI images, they determine if they see there are areas that seem to be suspicious for cancer and, more so, if they are clear enough to fuse with an ultrasound for biopsy.

If the images are not specifically clear, that doesn’t mean that a biopsy may not be warranted or that cancer is not present, just that this technology isn’t the right choice for the patient.

Diagnosed with prostate cancer?

Navigating a prostate cancer diagnosis and treatment options can be difficult. If you receive a cancer diagnosis, our cancer nurses are available and ready to help connect you with the right physician.

To connect with a cancer nurse at Penn Medicine, call 800-789-7366.

Staging Prostate Cancer

Staging prostate cancer can help physicians at the Abramson Cancer Center create a treatment plan designed specifically for you.