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Finding prostate cancer

Prostate cancer can be detected early using a PSA test and a digital rectal exam. Most of the time, the earlier you find cancer, the better. Prostate cancer seems to be different. Large, reliable studies haven’t been able to tell us clearly whether it’s a good thing to use these tests to look for prostate cancer.

  • Our recommendation

    We recommend that you talk to your doctor about your risk of prostate cancer and about the benefits and risks of finding it early.

    When is it time to talk to my doctor?

    It’s time to talk with your doctor if you’re a man and you:

    • will soon be 50 years old
    • are over 50 and you haven’t talked about prostate cancer with your doctor yet
    • may be at a higher risk of developing prostate cancer because you have a family history or if you are of African ancestry
    • have symptoms of prostate cancer
  • Tests for prostate cancer

    There are 2 tests available to help detect prostate cancer early.

    Digital rectal exam (DRE)

    A physical examination of the prostate gland through the rectum. The doctor inserts a gloved finger into the rectum to feel the prostate for lumps or anything else that seems unusual.

    Prostate-specific antigen (PSA) test

    A blood test that measures prostate-specific antigen, a substance made by the prostate. The normal level of PSA changes as you get older. Higher levels of PSA can be caused by several prostate problems, not just cancer. Sometimes men with prostate cancer have PSA levels that are not higher than normal.

    The PSA test cannot diagnose cancer. It can just indicate that there might be a problem with the prostate.

    Using these tests together is better than using either test alone. PSA testing together with a DRE may help find a dangerous cancer early when it is easier to treat. If a problem is found, more tests will be done to find out whether you have prostate cancer or another health problem. Further tests can include:

    • follow-up PSA test
    • transrectal ultrasound (TRUS) – a test that uses sound waves to make a picture of the rectum and nearby organs, including the prostate
    • biopsy of the prostate – a tissue sample of the prostate to be examined under a microscope
  • Normal PSA levels by age

    Your normal PSA levels will change as you get older.

    If you are 40–49, your normal range of PSA levels is 0.0–2.5

    If you are 50–59, your normal range of PSA levels is 0.0–3.5

    If you are 60–69, your normal range of PSA levels is 0.0–4.5

    If you are 70–79, your normal range of PSA levels is 0.0–6.5

    Reasons for having a higher than normal PSA level

    PSA levels may be higher than normal for your age for many reasons, such as:

    • enlarged prostate (benign prostatic hyperplasia)
    • inflamed prostate (prostatitis)
    • medical test on the prostate (such as biopsy or transrectal ultrasound)
    • cancer cells in the prostate
    • recent sexual activity

    No specific PSA level can confirm if you have cancer or not. But a high PSA level may suggest that cancer is present. More tests will be needed to confirm a diagnosis of cancer.



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