Problems and Treatments

First diagnosis

Often, there are no signs and symptoms of prostate cancer at the early stages of the disease. But there are several ways to diagnose the cancer and learn what stage it has reached, before treatment can be selected.

A doctor or nurse may perform a digital rectum examination (DRE). If any abnormality is felt, there are other tests which can confirm if cancer is present – and to what extent.

PSA (prostate specific antigen) blood test

Produced by the prostate gland, PSA is found in seminal fluid and, in small traces, in the blood. If someone has an infection, inflammation or cancer, increased PSA may leak into the blood. A simple blood test can measure to what extent PSA is present. A high PSA level may indicate presence of cancer cells but is not in itself diagnostic.

The PCA3 test

The PCA3 test is a new marker for prostate cancer based on a genetic analysis of cells in the urine. The urine sample is collected after a prostate is massaged by a doctor. The test is not normally used in isolation, but more often as a possible stage in your assessment by an urologist.

The PCA3 is a useful test if your blood test results show a high PSA reading, if you have a family history of the disease or if you have had biopsies in the past which have come back negative, in spite of a raised PSA.

The results of a PCA3 test must always be considered alongside a PSA measurement and, of course, any previous history of prostate investigations.

If you think the PCA3 test could be a suitable option given your circumstance, please book a consultation with one of our doctors.

Prostate biopsy

If a rectal examination and a PSA blood test suggest cancer may be present, conclusive diagnosis can be made via a biopsy – the removal of prostate tissue for microscopic examination.

The cancer is given a “Gleason grade” between 2 and 10 depending on the microscopic findings – Grade 2 indicates that the cells are almost normal and 10 indicates very aggressive Cancer. A 10 grading is uncommon, with most prostate cancers being a Gleason grade 6 or 7.

At the moment, a biopsy is the only way to be absolutely certain whether or not cancer is present.