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Specific tests for prostate cancer

These include:

Measurement of the Tumour marker

Prostate Specific Antigen (PSA) is the specific tumour marker for prostate cancer and is measured by a blood test.

PSA Reading Description
Less than 4.0 Within normal limits.
4.0 to 20.0 Raised – could be prostate cancer.
Greater than 20.0 Bony metastases from prostate cancer increasingly likely.

Digital Rectal Examination (DRE)

‘DRE’ findings refer to what is felt by a clinician examining the prostate by putting a finger into the back passage.

Transrectal ultrasound and biopsy

‘TRUSS’ or ‘TRUS’ of the prostate gland. The ultrasound probe is inserted into the rectum; the prostate, which lies next to the rectum, is clearly seen. Biopsies are taken through the wall of the rectum. The biopsy result gives information about the grade of cancer. This is a measure of the ability of the cancer to spread and cause harm. In prostate cancer, a special type of grade called the ‘Gleason’ grade is given.

‘Gleason’ Grading Description
Less than 7 Cancer likely to follow a benign course.
Greater than 7 Cancer likely to be invasive and life threatening - intensive treatment required.

Table showing death from prostate cancer by ‘Gleason’ grade

Gleason grade No. of men out of a 100 dying of prostate
cancer over the next 15 years based on ‘Gleason’ Grade
2-4 4-7%
7 42-70%
8-10 60-87%

Bone scan

Used to look for bony metastases.

Computerised Tomography (CT) or Magnetic Resonance Imaging (MRI) Scan

Used to look for local and distant spread of disease.

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Amended April 2008