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Should prostate be firm or soft?

A normal prostate feels firm. If there are hard spots on the prostate, your doctor may suggest additional testing to check for prostate cancer. During a PSA test, you will get a blood test.

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How is prostate cancer diagnosed?

Prostate cancer is diagnosed with a biopsy of the prostate. A biopsy is usually done if symptoms or a screening raises concern. A prostate cancer screening is a test your doctor uses to look for the disease before you have symptoms. There are two screening tests available: a digital rectal exam (DRE) and a prostate-specific antigen (PSA) test. You and your doctor will decide if you need a screening. However, these tests can only tell your doctor whether or not your prostate is healthy. Abnormal test results don’t always mean you have cancer. How often you should be screened depends on your age and your personal risk factors. During a DRE, your doctor will insert his or her gloved, lubricated finger a few inches into your rectum to feel your prostate gland. A normal prostate feels firm. If there are hard spots on the prostate, your doctor may suggest additional testing to check for prostate cancer. During a PSA test, you will get a blood test. A blood test involves inserting a small needle into a vein in your arm to take a sample of blood. The test measures the level of PSA (a substance produced by the prostate) in your blood. Men who have prostate cancer may have a higher level of PSA in their blood. However, a PSA level can also be high because of less serious causes, such as infection or an enlarged prostate. If your screening test results are abnormal, your doctor may recommend additional other tests to check for cancer. Those tests may include: Ultrasound. A transrectal ultrasound provides your doctor with a look at your prostate. During the test, an ultrasonographer (the professinoal who performs the ultrasound) will insert a small probe into your rectum. This probe sends out sound waves (called ultrasound) that bounce off your prostate. A computer uses the sound waves to create a picture of your prostate. A transrectal ultrasound provides your doctor with a look at your prostate. During the test, an ultrasonographer (the professinoal who performs the ultrasound) will insert a small probe into your rectum. This probe sends out sound waves (called ultrasound) that bounce off your prostate. A computer uses the sound waves to create a picture of your prostate. Biopsy. A transrectal biopsy is when your doctor removes a very small piece of your prostate to check it for cancer cells. A biopsy is a reliable way to diagnose prostate cancer. During the biopsy, your doctor will insert a needle through your rectum and into your prostate. The needle collects tissue from your prostate. Your doctor may take tissue samples from several different areas of your prostate. If your biopsy is normal, you don’t have prostate cancer. Talk to your doctor about whether another condition may have caused your symptoms or your high PSA level. Ask your doctor how often you should have checkups.

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If your biopsy results are positive for cancer, your doctor will grade and stage the cancer. Grading tells you how aggressive (fast-growing) the cancer is. Higher grade cancers are more likely to grow and spread. A common system of grading is called the Gleason score. Gleason scores range from 2 (not aggressive) to 10 (very aggressive). Staging tells you how advanced the cancer is. Also, it tells you how far it has spread. To determine the stage, your doctor may order imaging tests such as ultrasound, bone scan, computerized tomography (CT) scan, or magnetic resonance imaging (MRI). Stages I and II mean the cancer was caught early and hasn’t spread outside the prostate. Stages III and IV mean the cancer has spread to nearby tissues, organs, or to other body parts. Some medical professionals argue that screening isn’t necessary. For people who have fast-growing (aggressive) tumors, catching it early can help. Cancer is usually easier to treat and more likely to be cured when caught early. However, most cases aren’t fast-growing. Another argument is that PSA tests aren’t always accurate. In fact, a significant number of PSA tests are false positives. This causes unnecessary worry and expense for men who get the false positives. For these reasons, some medical organizations, including the U.S. Preventive Services Task Force and the American Academy of Family Physicians (AAFP), recommend against routine PSA screening for men of all ages. Talk to your doctor. Consider the pros and cons of screening, your health, individual risk factors, your preferences regarding diagnosis and treatment, and your doctor’s opinion and advice.

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