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Need more information to help you understand PSA testing or what happens after an elevated result? We explain the general process to investigate and diagnose prostate cancer.
Prostate cancer testing
Testing should start for all men in their 50s, or earlier if you have a family history of prostate cancer. The first step is a PSA blood test – available with your GP or urologist.
For further tests, you need a referral to a urologist, who is a specialist in the diagnosis and treatment of urinary system conditions.
Epworth urologists use a range of tests and the latest technology to precisely assess you. As prostate health is individual, your experience may involve some, or all, of the tests on this page.
Prostate-specific antigen (PSA) testing
The PSA blood test is the first step to investigate prostate cancer
PSA testing is available through your GP, who will speak with you about the potential benefits and harms of testing.
A PSA blood test measures your levels of a protein called prostate-specific antigen. This protein is only made by cells inside the prostate.
PSA testing is used because men with prostate cancer often have higher PSA levels. However, it is not a specific test for prostate cancer and you can’t receive a diagnosis based on your PSA results. PSA levels can rise due to other conditions, such as benign prostatic hyperplasia (enlarged prostate) or infection (prostatitis).
Digital rectal examination (DRE)
Also known as a prostate exam, this is an internal check of the outside of the prostate
A digital rectal examination is a way to find abnormalities that can happen with prostate cancer. With one finger, your GP or specialist feels inside the rectum and can assess part of the prostate this way. The test doesn’t take long and they use a glove and lubricant to ease any discomfort.
The next step
Not all prostate cancers can be found by digital rectal examination. Your doctor may recommend:
- multiparametric MRI
- prostate biopsy.
Magnetic resonance imaging (MRI) scan and multiparametric MRI scan (mpMRI)
An MRI scans and builds a picture of the prostate and body
The MRI machine uses magnets and radio waves to produce an image of the inside of the prostate. It shows tissue abnormalities that may be prostate cancer.
The multiparametric MRI (mpMRI) is an advanced method. This gives a detailed image that is most accurate in finding higher grade (more aggressive) prostate cancers.
If you are eligible, mpMRI scans to diagnose or monitor prostate cancer are now available through Medicare. Only specialist urologists, radiation oncologists and medical oncologists can order these scans through Medicare, not your GP.
The next step
- Your mpMRI result informs whether you need a prostate biopsy.
- If your specialist doesn’t recommend a biopsy, they will speak to you about follow-up appointments.
- A prostate biopsy is the final step needed to confirm a diagnosis of prostate cancer.
A surgical procedure to collect small samples of prostate tissue to test for cancer
In a prostate biopsy, a urologist or radiologist inserts a thin needle into the prostate to remove some tissue. This is called a transperineal biopsy. A needle is inserted through the skin of the perineum (the skin between the scrotum and rectum). You will have a general anaesthetic (where you are unconscious) for this procedure.
This tissue is examined and tested in the lab to confirm if cancer is present.
The next step
- An appointment with your specialist to take you through your results.
- No matter the outcome of the biopsy, they are there to answer your questions and outline a plan for what happens next.
Receiving a diagnosis of prostate cancer
Your specialist will carefully explain your test results and when you’re ready, guide you on the next course of action.
Each person responds differently to getting a prostate cancer diagnosis. Many people find it hard to take in all the new words and information right away. This is where a support person at your appointment can help you debrief and remember information you’ve been given. Your specialist and care team are also there for you in this difficult time.
After diagnosis, receiving a clinical stage is generally the next step.