What Are 2 Screenings Performed to Detect Prostate Cancer?

Medically Reviewed on 2/2/2023
Screenings to Detect Prostate Cancer
The five-year survival rate for localized prostate cancer is 97 to 98 percent.

The two most commonly performed screening tests to detect prostate cancer are the prostate-specific antigen (PSA) test and digital rectal examination (DRE).

PSA is a blood test to measure the level of prostate-specific antigen, whereas DRE is done by inserting a gloved lubricated finger into the rectum, allowing one to feel the edges and surface of the prostate gland to detect any potential abnormalities (bumps or hard areas).

The following are the cutoff points of PSA levels:

  • Below 4 ng/mL: Normally seen in most men without prostate cancer
  • Between 4 and 10 ng/mL:  About one in every four men has a risk of having prostate cancer
  • Above 10 ng/mL: The risk of prostate cancer is over 50 percent

Other tests that may help diagnose prostate cancer include:

  • Prostate health index: A blood test approved by the FDA for men who have PSA scores between 4 and 10.
  • Prostate cancer gene 3 (PCA3) RNA test: For men with high PSA levels and a biopsy not showing cancer changes.
  • Biopsy: A procedure wherein the doctors remove a tissue sample from the prostate and analyze it under a microscope.
    • If prostate cancer is found on a biopsy, they are graded using the Gleason score based on the abnormality of the cancer cells:
      • Grade I: Cancer cells look similar to the normal prostate tissue.
      • Grades II, III, and IV: Are assigned to cancer that has featured in between the extremes.
      • Grade V: Cancer looks very abnormal.

What is prostate cancer?

Prostate cancer is the uncontrolled (malignant) growth of the cells of the prostate gland. It is the second most common cancer, estimated to affect one in every eight men in the United States.

The prostate is a walnut-sized gland that surrounds the male urethra (the tube through which urine is voided).

The prostate gland is a part of the male reproductive system and is responsible for secreting various substances that form semen.

What are the symptoms of prostate cancer?

The most commonly seen symptoms of prostate cancer include:

What causes prostate cancer?

Although the exact cause of prostate cancer is unknown; however, researchers speculate the following reasons:

  • Mutation (an abnormal change) in the genetic material in a cell in the prostate gland.
  • The abnormal cell grows and produces more cells of its kind uncontrollably, forming cancer or a tumor.
  • The consequent abnormal cells have an increased need for nutrients that deprive the healthy cells of nourishment causing metabolic starvation.

Certain factors that may increase the risk of prostate cancer include:

  • Advancing age: 60 percent of prostate cancer cases are diagnosed in men who are 65 years or older.
  • Genetics: Abnormal mutations in BRCA or BRCA2, CHECK2, RAD15, or ATM genes may increase the risk of prostate cancer.
  • Family history: The risk is higher in men whose brothers and fathers may have prostate cancer.
  • Ethnicity: African American and Caribbean men and men of African ancestry are more vulnerable to getting the disease.
  • Smoking: Is directly linked to an increase in the risk of death from prostate cancer.
  • Obesity: Obese men are at a higher risk of getting an aggressive form of prostate cancer.
  • Diet: Men who consume dairy products and red meats in excess may have a higher risk of prostate cancer.
  • Chemical exposure: Men frequently exposed to metal cadmium, such as welders, battery manufacturers, and rubber workers, are more vulnerable to prostate cancer.


Prostate Illustrion Browse through our medical image collection to see illustrations of human anatomy and physiology See Images

5 types of prostate cancer

Depending on the cells from which it arises, prostate cancer is categorized into the following five types:

  1. Adenocarcinoma
  2. Small cell carcinomas
  3. Neuroendocrine tumors
  4. Transitional cell carcinomas
  5. Sarcomas

How is prostate cancer staged?

Prostate cancer can be categorized into the following four stages:

  1. Stage I: The tumor involves one-half of the prostate.
  2. Stage II: The tumor is localized to the prostate.
    • It can be further divided into three substages:
      • Stage II A: The tumor involves the half side of the prostate that has well-differentiated cancer cells.
      • Stage II B: The cancer cells are moderately differentiated.
      • Stage II C: The cancer cells are moderately or poorly differentiated.
  3. Stage III: A high-grade locally advanced type of prostate cancer.
    • It can be classified into three substages:
      • Stage III A: Cancer has spread beyond the outer layer of the prostate into nearby tissues or the seminal vesicles.
      • Stage IIIB: The tumor has spread outside of the prostate gland and has invaded nearby structures including the bladder or rectum.
      • Stage IIIC: The cancer cells are poorly differentiated.
  4. Stage IV: The tumor has spread beyond the prostate gland.
    • It can be further divided into two substages:
      • Stage IVA: The tumor has spread to the regional lymph nodes.
      • Stage IVB: Cancer has spread to distant lymph nodes or other parts of the body such as the bones.

How is prostate cancer treated?

Treatment of prostate cancer usually includes the following:

  • Active surveillance: In cases of localized and slow-growing cancer, the doctor regularly conducts tests to check for the growth of cancer and initiates timely treatment if cancer turns aggressive. 
  • Watchful waiting: Symptomatic treatment is provided without doing any tests. It is typically done in men who are expected to live for less than 10 years.
  • Surgery: Involves the removal of the entire prostate gland, with or without the removal of the surrounding tissues.
  • Radiation therapy: High-energy radiation is administered to destroy cancer cells.
  • Chemotherapy: Cancer cells are killed using drugs.
  • Hormone therapy: Involves medications to block the effect of androgens responsible for cancer growth.
  • Targeted therapy: Cancer cells are targeted using medications without harming healthy cells.
  • Biological therapy: The body’s immunity is used to kill cancer cells.
  • Internal radiation therapy or brachytherapy: Small radioactive pellets are inserted into or near a prostate tumor.
  • Cryotherapy: Little needles or probes are inserted into the prostate to inject extremely cold gasses that kill the cells.
  • High-intensity focused ultrasound: Cancer cells are killed using high-energy sound waves.

What is the survival rate of prostate cancer?

The five-year survival rate for localized cancer that hasn’t spread outside of the prostate is 97 to 98 percent. However, if cancer has spread outside of the gland, the five-year survival rate drops significantly to about 33 percent.

Medically Reviewed on 2/2/2023
Image Source: iStock image

Prostate Exam Cleveland Clinic https://my.clevelandclinic.org/health/diagnostics/22764-prostate-exam

Prostate Cancer Screening National Cancer Institute https://www.cancer.gov/types/prostate/patient/prostate-screening-pdq

Prostate Cancer Screening Medline Plus https://medlineplus.gov/prostatecancerscreening.html#:~:text=A%20PSA%20test%20or%20a,harms%20of%20prostate%20cancer%20screening.

Prostate Cancer: Screening American Society of Clinical Oncology https://www.cancer.net/cancer-types/prostate-cancer/screening