How is prostate cancer diagnosed?

You might visit your GP with symptoms, such as problems passing urine or urinating more frequently, or you may have had a routine blood test called a PSA test, which has detected increased levels of Prostate Specific Antigen. 

Your GP may carry out a digital rectal examination (DRE), during which your prostate is assessed. A DRE involves your doctor feeling your prostate through your rectum (back passage). Some men may find the DRE test a little uncomfortable or embarrassing but it doesn’t take long and is an important part of the diagnostic process. If your prostate feels abnormal or if your PSA level is elevated your GP will refer you to a specialist for further tests.

These symptoms can be caused by various health conditions and do not necessarily mean you have cancer, but it’s important to diagnose what is causing these changes.

Once you have been referred and met with a specialist consultant an MRI scan may be recommended to look for any changes to your prostate. If any changes are shown on the scan a biopsy can be performed to collect some tissue, this will be reviewed in a laboratory. If your biopsy finds any cancerous cells, further tests can confirm the stage and grade of the cancer, your consult may also recommend further scans to make sure your cancer hasn’t spread to other parts of your body. These tests and scans will enable your medical team to provide a comprehensive diagnosis which will inform the best treatment plan for you. 

What is PSA?

PSA stands for Prostate Specific Antigen, which is a protein made by cells in the prostate gland. When there's a problem with your prostate gland, it releases more PSA which can then be found in your bloodstream.

PSA testing

A PSA test is a simple blood test that measures the amount of PSA circulating in your bloodstream and is the most common screening tool for prostate cancer. If your PSA level is high, it tells your doctor that there is something happening in your prostate which needs further investigation. 

Whilst a high PSA level can be a sign of prostate cancer, it can also be high for other reasons which aren't cancer, such as prostate enlargement and inflammation; these conditions are not usually serious and there many treatments available.

The PSA test cannot diagnose prostate cancer, it's just a first step. So, if your PSA is high your doctor will refer you for further tests to find out more.

What is active surveillance?

Active surveillance means that rather than starting treatment right away your consultant will monitor your cancer closely. This is because some prostate cancers grow slowly and therefore your consultant may recommend waiting to see how the cancer develops before starting any treatment. Active surveillance means that you can have regular tests to check if your cancer is growing or changing and if so you can begin treatment.

Active surveillance may be recommended if you have a localised cancer, this means the cancer is only in your prostate gland, or if you have a low-risk cancer. If active surveillance may be beneficial then your consultant will discuss this with you in detail as part of your treatment recommendations. You can ask questions and consider the pros and cons of starting treatment right away or choosing active surveillance, your medical team will ensure that you have all the information you need to make an informed decision about your care.

Expert prostate cancer multidisciplinary teams

At HCA Healthcare UK, our multidisciplinary team (MDT) of prostate cancer experts come together to discuss your individual diagnosis. They’ll consider all the different options and make a recommendation on the best treatment plan for you. Your consultant will discuss this treatment plan with you and along with your Clinical Nurse Specialist they can answer any questions you may have so that you can make an informed decision about your treatment and care. 

An annual health check identified my prostate cancer

John Deans went for his annual health screen - offered as part of his employer health scheme. John was seemingly a fit and healthy 59-year-old with no signs or symptoms that suggested otherwise.

However, in fact, this health screen prompted further tests, where it was discovered that John had prostate cancer. Here, John speaks about his experience at London Bridge Hospital, and highlights just how important it was that he chose to attend his annual health screen. 
GP with patient

Getting a second opinion

If you have been diagnosed with cancer, whether or not you have started treatment, a second opinion can give you reassurance and peace of mind.  

Our second opinion service is led by expert consultants.  They will provide a comprehensive review of your current and past medical history, to identify the best treatment options for you. This review may identify new treatment options or simply confirm you are already receiving the best treatment.  Either way it can help you make an informed decision about what is best for you.
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