How is Prostate Cancer Diagnosed?

Rectal Examination

Once symptoms are present which raise the suspicion of prostate cancer, the doctor will do an examination to check for an enlarged prostate. To do that, the doctor places the finger in the rectum and checks whether the prostate is enlarged or not and whether the enlargement is possibly cancer or not.

A blood test for PSA is also done which will give additional information about the prostate.


A PSA test may show a normal PSA level or an elevated level. The PSA level increases slightly with age and a raised PSA doesn’t always mean the presence of cancer. If the PSA is very much elevated, the chances of cancer being present are higher. Sometimes, an infection in the prostate gland can also elevate the PSA.


If there is a suspicion of prostate cancer on examination and/or PSA, a biopsy is done of the prostate gland. This is usually done through the rectum with the help of an ultrasound scan and is called a trans rectal biopsy of the prostate. (TRUS biopsy)

Following the biopsy, some people may notice mild discomfort, blood in the urine or semen discharge.

Biopsy Result

The result will be available a few days after the biopsy, and it may confirm the presence of prostate cancer. If prostate cancer is found, it is given a grade called the Gleason grade. This grade is from 6 to 10 with 6 being the least aggressive and 10 being the most aggressive. This score of 6 to 10 is given as a sum of two numbers, for example Gleason 10 is 5+5 and so on. Based on the grade, the cancer can be classified as low grade (Gleason 6), intermediate grade (Gleason 7) and high grade (Gleason 8-10).

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