Prostate Cancer Diagnosis

According to the American Cancer Society, about 1 in 8 men will be diagnosed with prostate cancer during his lifetime. Prostate cancer is more common in older men. In fact, about 6 in 10 patients are 65 or older when diagnosed. It is rare in men under 40. The average age of men at diagnosis is about 66. Prostate cancer is also more likely to occur in non-Hispanic Black men.

Diagnosing prostate cancer early can sometimes be difficult because symptoms are often not felt until the cancer has reached a more advanced stage. Still, some men do experience signs and symptoms.

There are several signs and symptoms to look for when diagnosing prostate cancer. If you are experiencing any of the following symptoms, speak to your doctor:

• Difficulty urinating or holding urine
• Weak or interrupted flow of urine
• Blood in the urine or semen
• Frequent urination (mostly at night)
• Pain or burning sensation while urinating
• Pain when ejaculating
• Erectile dysfunction
• Pain or stiffness in the lower back, pelvis, hips or upper thighs

Your Winship care team may use one or more test and procedure to confirm a prostate cancer diagnosis:

Prostate-Specific Antigen (PSA) test: This is a blood test used to assess a patient’s level of PSA, a protein made by cells in the prostate gland. A higher-than-normal level of PSA might indicate a problem with the prostate, including cancer.

If PSA levels are high (typically over 4ng/ML), further diagnostic tests are needed to confirm a prostate cancer diagnosis. It is important to note that an abnormal age-adjusted PSA test may be an indication of prostate cancer, but that is not always the case. There are several reasons why a man’s PSA might be high, including:

• An enlarged prostate
• Older age
• Recent ejaculation
• Frequent cycling
• Certain hormone medications, such as testosterone replacement therapies
• Urological procedures

Talk with your doctor to learn more about PSA levels and any questions you may have.

Digital Rectal Exam (DRE): A doctor inserts a lubricated, gloved finger into the rectum to feel for abnormalities, growth or hardness of the prostate.

Biopsy: A biopsy is a procedure in which a sample of tissue is taken from the prostate and then viewed under a microscope to check for cancer cells.

Prostate Health Index (phi): This is a more precise blood test that may help distinguish aggressive cancer from low-risk cancer. This is a very new technique that is currently being researched at Winship.

Specialty imaging techniques. Specialty imaging techniques provide for better diagnosis and treatment of various cancers. At Winship, our highly experienced radiologists offer the most advanced imaging available for all phases of prostate cancer including multiparametric (3D) prostate MRI to guide biopsies more precisely. Our radiology program is home to the only PET-MRI in Georgia that combines the power of MRI and PET in one machine.