Testing

How prostate cancer is diagnosed
If your doctor thinks you might have prostate cancer, a number of tests can be done to find out for certain. These tests will also check the size of the cancer and find out if it has spread. It is important that you understand what it will mean if a test shows you have cancer. You need to think beforehand about whether you would want to have treatment. This will depend on your age, health, what you want and the stage of the cancer. Your doctor can help you decide what is best for you.

You may have some or all of the following tests:
Blood test (PSA) to measure levels of prostate specific antigens in the blood. If the levels of PSA are high and a rectal examination is abnormal, there is about a 60% chance of prostate cancer being found. However, most men with a normal feeling prostate and a slightly raised PSA level do not have cancer.
Digital rectal examination (DRE) where the doctor places a finger inside the rectum, or back passage, to check for changes to the surface of the prostate
Biopsy Bone scan
Computerised tomography (CT) scan
Magnetic resonance imaging (MRI)
‘Staging’ the disease
The tests described above show whether you have cancer. They will also show where the cancer is and whether the cancer cells have spread to other parts of your body. This helps your doctors ’stage’ the disease.
‘Stage’ describes the extent of the cancer in your body. It helps show which treatment is needed. It also is a guide to prognosis.
A common ’staging system’ used for prostate cancer is the TNM system
T = tumour       N = nodes     M = metastases.

• T followed by a number between 1 and 4 shows whether and how far the cancer has spread in the area of the prostate. A higher number after the T (for example, T3 or T4) means it has spread beyond the prostate into tissue around the prostate, or to nearby organs (the bladder or rectum). Men with T1 or T2 disease have cancer that is probably confined within the prostate (early prostate cancer).
• N1 means the cancer has spread to a lymph node or nodes near the prostate. N0 means the cancer has not spread to any lymph nodes.
• M followed by 1a, b or c shows that the cancer has spread to bone or other sites.

Ask your doctor to explain the stage of your cancer in a way you can understand. This will help you choose the best treatment for your situation.

If you would like more information visit:
The Andrology Australia site: www.andrologyaustralia.org
Prostate Cancer Foundation of Australia: www.prostate.org.au