Prostate cancer is usually checked using a blood test, a rectal exam, and, if needed, scans and a biopsy to confirm whether cancer is present.

Initial checks

Doctors typically start with:

• A prostate-specific antigen (PSA) blood test, which measures a protein made by the prostate; higher levels can suggest a problem, including possible cancer.

• A digital rectal exam (DRE), where a doctor gently inserts a gloved, lubricated finger into the rectum to feel the prostate for lumps, hardness, or asymmetry.

These tests do not by themselves prove cancer, but they help decide whether further investigation is needed.

Tests if cancer is suspected

If the PSA or DRE is abnormal, or symptoms and risk factors raise concern, specialists may order:

• An MRI scan of the prostate (often a multiparametric MRI) to look for suspicious areas and see if anything appears to extend beyond the gland.

• A prostate biopsy, usually guided by ultrasound and/or MRI, in which small tissue samples are taken with a needle and examined under a microscope; this is the definitive way to diagnose prostate cancer.

In some cases, additional imaging such as specialized PET scans or bone scans is used to check whether proven cancer has spread.

When to talk to a doctor

Men are often offered PSA-based screening starting around age 50–55, earlier (around 40–45) if there are higher risks such as a strong family history or being of African or Caribbean ancestry. If there are urinary symptoms, blood in semen or urine, or concerns about risk, a primary care doctor or urologist can explain the pros and cons of PSA testing and DRE for that individual.