As part of a regular check-up, a digital rectal examination (DRE) is recommended in order to detect any irregularities in the prostate. This may be an uncomfortable examination but is rarely painful. An enlarged gland will feel hard and possibly irregular in shape.
A Prostate Specific Antigen (PSA) test may be requested if any abnormality is found. This measures a protein in the blood which rises in concentration when there are prostate problems. In themselves, these two tests will not distinguish between cancer or a benign enlarged prostate and so, if an abnormality is found, an ultrasound scan will be carried out. A biopsy will then determine if the prostate is cancerous or benign.
Information from diagnostic tests will help determine the best treatment approach. Depending on the stage of cancer development, a number of treatment options may be offered:
- Observation only (termed ‘active surveillance’) – monitoring the disease through regular check-ups, but delaying treatment until the disease shows signs of progressing or symptoms become troublesome
- Radical prostatectomy – an operation to remove the prostate gland and the immediate surrounding associated organs, such as the seminal vesicles
- External beam radiotherapy
- Radiotherapy using radioactive ‘seeds’ of Iodine125, which are permanently inserted into the prostate
- An operation to reduce male hormone production by removal of one or both testicles
- Medicines to suppress the production and action of the male sex hormones.