Cancer Care

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Diagnostic Tests for Prostate Cancer

The Prostate program encourages patients to contact us directly for diagnostic or treatment information and consultation by calling (603) 650-5091. A physician referral is not required.

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A PSA (prostate specific antigen) test is a simple blood test and is an increasingly common component of a regular physical exam for many men along with a digital rectal exam (DRE) of the prostate. One result of the increase in PSA testing is an increase in reports of high PSA scores. A high PSA does not mean prostate cancer, but it does mean that more diagnosis is needed to determine what is the cause. Similarly, a lump or irregularity in the prostate as detected by a DRE has to be explained. Often if a primary care physician suspects prostate cancer, they may refer a patient to a urologist to take a tissue sample or biopsy.

Patients who have been informed they have a high PSA or that a biopsy indicates prostate cancer need further diagnosis and tests to determine what to do to treat the problem. Contact the Prostate Program at (603) 650-5091 for more information about your diagnostic and treatment options and to schedule an appointment at the Prostate Cancer Risk Clinic.

Our team performs the most comprehensive diagnostics possible to ensure that we fully understand the extent of the disease in each patient.

Prostate Cancer Risk Clinic

A Digital Rectal Exam (DRE) and a Prostate Specific Antigen (PSA) test are often part of a physical exam for men over the age of 50. If a patient's test resulted in a high PSA level, or if the DRE detected an abnormality, further diagnosis is needed to determine if the cause is the result of prostate cancer or something else. Elevated PSA levels can be caused by recent sexual activity or may be a normal result of aging, so it is not by any means a definitive indicator of prostate cancer. The Prostate Cancer Risk Clinic provides the most through examination and diagnostic tests available to determine a patient's condition.

As part of the Risk Clinic, several diagnostic tests may be required; all can be performed the day of the clinic appointment:

  1. H-Quest health questionnaire to get comprehensive health information (may be taken online prior to Clinic visit)
  2. Digital rectal exam to examine the prostate for swelling and irregularities
  3. PSA test to take additional PSA levels
  4. Transrectal ultrasound to record images of the prostate
  5. Prostate biopsy, a 15-minute procedure performed under local anesthesia that takes 6 - 12 samples from the prostate
Prostate cancer

Once a urologist has confirmed a diagnosis of prostate cancer, patients are referred to a specialist for additional tests to determine the severity and extent of the disease and to determine the best course of treatment. Additional tests may include:

  • Prostate cancer mapping and volume estimation - To determine the precise location and size of tumors we perform 12-core biopsies that take samples from the entire prostate.
  • Molecular diagnostic testing - We can perform tests to identify genetic markers that enhance the ability to determine the biological aggressiveness of individual prostate cancers and can help to identify the best therapeutic management choices.
  • Immunohistochemical staining - To establish a precise diagnosis of what type of cancer is present, we analyze proteins and antibodies in tissue samples.
  • Prostascint scan - We are the only cancer center in the region that performs this dye test to detect cancer recurrence.
  • Cytogenetics - In order to improve diagnosis and help determine the best course of treatment, we perform this test to see if chromosomal translocations are present in the malignant cells.