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Conditions: Prostate Cancer

Diagnosing Prostate Cancer


The 2 ways doctors screen for prostate cancer are through digital rectal examination (DRE) and PSA test. Your doctor can perform a DRE during your annual physical examination. You will be asked to either bend over, or lie on your side. Your doctor will briefly insert a lubricated gloved finger into your rectum to examine the size, contour and consistency of your prostate gland.
Prior to your examination, you may also be sent to have a blood test that will measure the level of PSA in your blood. Most experts agree that men with no risk factors should be screened for prostate cancer beginning at age 50 years. For men at high risk, screening should begin at age 40 years (or possibly earlier). It has recently been shown that fewer than 30% of  men with PSA values between 4 and 10 ng/ml have prostate cancer, in contrast to 42% to 70% of men with PSA values greater than 10 ng/ml have cancer.
If the DRE and PSA tests suggest prostate cancer, the doctor will recommend you undergo a biopsy. During this procedure, your urologist will insert a needle into the prostate to remove a small sample of tissues that will be closely examined by a pathologist. The procedure may be uncomfortable but is frequently performed in the doctor’s office using lidocaine jelly or injection. The tissue cells will be examined under a microscope for abnormalities, and they will be graded based upon how different they look from normal cells.

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