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. These tests are often 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, it is recommended that these tests be given starting at age 40. In fact, some organizations even recommend that these tests be given to all men starting at age 40.
A digital rectal exam is usually conducted first. During this exam, your provider will feel your prostate gland through your rectum. This examination can be somewhat uncomfortable, but fortunately it only lasts for a brief time. During the DRE, your provider can determine whether your prostate has any irregularities, such as hard spots, soft spots, or lumps that require additional tests. If a prostate infection is suspected, your provider might 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 you have urination problems or if the DRE or PSA tests indicate that you might have a problem, your provider may recommend additional tests.