Diagnostic Tests for Advanced Prostate Cancer

Health Writer
Thinkstock

There are often no symptoms of early stage prostate cancer. Because of that, many people are not diagnosed until they have advanced prostate cancer. This means that the cancer had spread from the original tumor site in the prostate. There are two types of advanced prostate cancer:

  • Locally advanced prostate cancer - the cancer has spread but only to areas near the prostate
  • Advanced or metastatic prostate cancer - the cancer has spread to other parts of the body, such as the bones, lungs, liver, brain or lymph nodes outside of the pelvic area

Early stage prostate cancer is usually found during a routine prostate exam which often includes a physical examination of your prostate area and a digital-rectal exam. Your doctor might also request a prostate-specific antigen test (PSA), a blood test. This test alone can’t diagnose prostate cancer, however, it can indicate if further screening is necessary and if you are found to have prostate cancer it can help with determining what stage cancer you have.

If either your physical examination or the results of your PSA test indicate you might have prostate cancer, your doctor might request additional screening and testing, including:

  • A comprehensive examination which might include a follow up physical examination, a discussion of risk factors and family health history.
  • Urine flow test - a test that measures the flow of your urine although other prostate problems, such an enlarged prostate, can also cause low urine flow so the results of this test do not necessarily point to prostate cancer
  • Imaging studies - a transrectal ultrasound checks the size of your prostate. Although an enlarged prostate is not necessarily a sign of prostate cancer it can help your doctor analyze your risk for developing prostate cancer.
  • Prostate biopsy - an evaluation of cells from your prostate. The cells are obtained using a thin needle inserted into your prostate. This is normally done if other screening methods have indicated there is a high chance that you have prostate cancer.

In addition, there are some new prostate cancer screening tools that your doctor might request. Because these diagnostic tests are still in research status, your doctor may not have access to them or may not feel comfortable using tests that are not yet available as mainstream testing methods. Some of these methods include:

  • Looking at biomarkers - using molecular testing, laboratories analyze urine for a gene that is found when prostate cancer is present but is not found in normal prostate tissue.
  • Liquid biopsy - a blood test that analyzes and detects cancer cells called circulating tumor cells. A 2015 study found that about one-half of those with prostate cancer had cancer cells detectable by this type of test.

You should work with your doctor to determine which screening tests are necessary and discuss what your doctor hopes to learn from each test he or she requests. Not everyone needs all of the screening tests. If you are diagnosed with prostate cancer, your doctor might order additional tests to determine whether the cancer has spread to other parts of your body and will discuss the best treatments for you.

References: How is Prostate Cancer Diagnosed?: American Cancer Society What Tests Can Detect Prostate Cancer Early?: American Cancer Society