In the past, most men with prostate cancer were diagnosed after presenting with new urinary symptoms, including blood in the urine, or a significant change in how they were able to urinate (frequency, weak stream, etc.). This is not a common presentation however, since most men will have some of these symptoms as a normal part of aging.

A more common sign of cancer is the finding of a nodule or abnormality during a routine DRE, or digital rectal examination. Most men will have a DRE during their annual physical exam. If asymmetry, firmness or nodularity is detected, a referral to a Urologist for investigation will likely be made.

However, in the last decade, most men with prostate cancer have a perfectly normal DRE and no urinary symptoms at all, but instead present with an abnormal blood test called the PSA, or prostate specific antigen. PSA is a protein that is made only by normal or cancerous prostate cells. All men have a detectable amount of PSA in their bloodstream, which is there because it can “leak” into the blood from the prostate at low levels. Prostate cancer cells also may make this PSA, and cause more of it to leak into the bloodstream where it can be detected during a routine blood test. If the PSA level is high (many labs have the “normal range” between 0 and 4.0 ng/ml), or if the PSA level has risen significantly over a short time period, a man might be referred to a Urologist for further investigation. It should be noted that an elevated PSA does not mean that prostate cancer is present, as other benign conditions can cause an elevation in PSA, such as a prostate infection (prostatitis), or the normal enlargement of the prostate with age (due to BPH or benign prostatic hypertrophy), etc.

Information for this section was graciously provided by the physicians and staff of Advanced Radiation Centers of New York. For further information on prostate cancer, please visit the ARC website.