Prostate Cancer Tests and Diagnoses

A biopsy is needed to tell if you have prostate cancer. A sample of tissue is removed from the prostate and sent to a lab.

Your doctor may recommend a prostate biopsy if:

  • You have high PSA level
  • A rectal exam shows a large prostate or a hard, uneven surface

The results are reported using what is called a Gleason grade and a Gleason score.

The Gleason grade tells you how fast the cancer might spread. It grades tumors on a scale of one to five. You may have different grades of cancer in one biopsy sample. The two main grades are added together. This gives you the Gleason score. The higher your Gleason score, the more likely the cancer is to have spread past the prostate:

  • Scores 2 to 5: Low-grade prostate cancer
  • Scores 6 to 7: Intermediate- (or in the middle-) grade cancer. Most prostate cancers fall into this group.
  • Scores 8 to 10: High-grade cancer

The following tests may be done to determine whether the cancer has spread:

CT scan

The PSA blood test will also be used to monitor your cancer after treatment. Often, PSA levels will begin to rise before there are any symptoms. An abnormal digital rectal exam may be the only sign of prostate cancer (even if the PSA is normal).