How is the disease diagnosed?

Diagnosis of prostate cancer begins with a medical history and physical exam. The healthcare provider will do a digital rectal exam. This involves inserting a gloved finger into the man's rectum to feel the prostate.

The PSA test, and a more refined version of it, may help in diagnosing prostate cancer. High levels of PSA suggest, but cannot prove, that a man has prostate cancer. However, very high levels of PSA can diagnose the disease. Normal ranges for PSA increase with age and are different according to race.

If prostate cancer is suspected, a biopsy may be done. During the biopsy, a needle is inserted into the prostate gland to obtain a small sample of tissue. The healthcare provider may order a transrectal ultrasound. This test uses sound waves to examine the inside of the gland. It can be used to guide the healthcare provider during a biopsy. If several areas of the prostate are in question, a number of biopsies may be done. The tissue is sent to a lab where it will be checked for cancer.

Prostate cancer is graded and staged for aggressiveness based on how far it has spread throughout the body.

CT scans and bone scans help in staging. Sometimes staging only becomes clear at the time of surgery.