The cancer is not the only type of disease affecting the prostate gland so for an early and accurate diagnose the screening tests are often recommended.

These screening tests include two procedures: the digital rectal exam or DRE, when the doctor searches for a hardness or a lump on the surface of the prostate gland by inserting a gloved finger into the rectum, and the prostate specific antigen blood tests or PSA, used as an indicator for determining how spread is the tumor in the organism.



If the PSA test result indicates under four nanograms per milliliter of blood then it is considered as a normal result and a result higher than ten is considered abnormal. In this latter case the doctor will recommend a prostate biopsy which is a procedure described as withdrawing of one or two small pieces of the prostate tissue, using a needle trans-rectally, done under the guidance of the ultrasound images of the prostate area.



If the cancer has spread to the bones, radionuclide bone scans can confirm that; if we are talking about affected surrounding organs, coaxial tomography or CAT scans and magnetic resonance imaging or MRI scans can tell how much the cancer has spread in these areas; there is also a new method of biopsy known as the prostate mapping that combines the template-guided multiple biopsies with the multi-sequence MRI scans and is done under general anesthetic, by taking thirty to fifty biopsies through the skin area found in front of the back passage.

If cancer is diagnosed, the Gleason scale is used to classify the stages of the cancer: scores from two to four indicate a slow growing tumor, scores from five to six indicate an intermediate aggressiveness of the tumor, while scores from seven to ten indicate the rapid growth of the cancerous tumor; the staging process or the TNM system indicates how spread is the disease, and there are usually four stages: stage I, stage II, stage III and stage IV.

The TNM abbreviation stands for tumor, describing the size of the main area of the cancer, nodes or if the prostate cancer has already spread to the lymph nodes and just how much, and metastatis or the distant and advanced spread of the cancer to the liver or bones.

In stage I, the cancer is found only in the gland, has a microscopic size and could be detected only if prostate tissue parts are analyzed. In stage II, the tumor has grown only inside the gland and you could feel a lump. In stage III the tumor has barely spread to the surrounding areas of the prostate. In stage IV the cancer is metastasized and has spread to the bones, lungs, liver and the lymph nodes.

There is also the Whitmore-Jewett staging, similar to the TNM staging, one obvious difference being the replacement of the roman numerals with Latin letters, and so stage I become stage A, stage II becomes stage B, stage III becomes stage C and stage IV becomes stage D.

In stage A, the tumor is not clinically detectable, in stage B the tumor is organ-confined and can be detected after medical examinations, in stage C the tumor began spreading outside the prostate organ and in stage D, the tumor has already infected other organs.

The staging process is very important because the future treatment procedure will be chosen in accordance to the result obtained.