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Dr. Reynolds
There are a variety of tests that providers use to diagnose diseases of the prostate. The most common tests include digital rectal exams, known as DREs, and blood tests for prostate-specific antigen, known as PSA tests. Dr. Patel, can you tell us more about these tests?

Dr. Patel
Definitely, Dr. Reynolds. DREs and PSA tests are sometimes included in routine physical examinations for men over the age of 50. For African-American men and men with a family history of prostate cancer, providers may recommend that these tests be given starting before age 50.

A digital rectal exam is usually conducted first. During this exam, the provider uses a gloved, lubricated finger to feel the prostate gland through the rectum. This examination can be somewhat uncomfortable, but fortunately it only lasts for a brief time.

During the DRE, the provider can determine whether the prostate has any irregularities, such as hard spots, soft spots, or lumps that require additional tests. If a prostate infection is suspected, the provider may massage the prostate during the exam to obtain fluid for examination under a microscope.

PSA blood tests measure blood levels of a protein produced by prostate cells known as prostate-specific antigen. The level of PSA tends to be higher in the blood of men who have prostate cancer. However, it's important to keep in mind that an elevated level of PSA does not necessarily mean that prostate cancer is present, and it is possible to have prostate cancer even if the PSA level is low.

If the DRE or PSA tests suggest that prostate cancer is a possibility, additional tests may be ordered to confirm diagnosis. These tests may include:

  • Urinalysis
  • Imaging tests, such as transrectal ultrasound, MRI, or CT scans, or
  • Biopsy