Confirm that you do have cancer!

Confirm by having an exam by a urologist

• sometimes they use Digital rectal exam (DRE): The doctor gently inserts a gloved, lubricated finger into the rectum for a few seconds to feel the back of the prostate for lumps, hard areas, or enlargement. 

• PSA test: A small blood sample is taken to measure prostate-specific antigen, a protein made by the prostate; higher or rapidly rising levels can signal cancer or other prostate issues but are not proof of cancer by themselves.

IMPORTANT: Even if your general doctor performed both tests - insist to be referred to a urologist!

• If PSA or DRE results are abnormal, your doctor may recommend repeat PSA tests, imaging such as ultrasound or MRI, or a prostate biopsy to look directly at prostate tissue. Biopsies carry small risks such as temporary bleeding, infection, or urinary problems, which your doctor will review beforehand.
• Main reasons for prostate MRI (magnetic resonance imaging):

  • To look more closely after an elevated PSA or abnormal exam, helping to see whether there are suspicious areas that might be significant cancer.​

  • MRI shows soft tissues very clearly without using radiation, so it can better distinguish aggressive tumors from harmless or slow‑growing ones.

  • To decide if a biopsy is necessary and, if so, to guide targeted biopsy to the most abnormal regions instead of sampling randomly.

• Biopsy:

  • A prostate biopsy for cancer suspicion is typically done as a needle procedure, either transrectal (through the rectum) or transperineal (through the skin between the anus and scrotum), guided by ultrasound or MRI to target suspicious areas. 

  • Preparation steps: You may receive antibiotics to prevent infection, a mild sedative or local anesthetic for comfort, and sometimes an enema to clear the rectum. Staff will review allergies, medications, and implants before starting.​

  • Procedure for transrectal biopsy (most common): Lie on your side with knees to chest; a lubricated ultrasound probe (finger-sized) is inserted into the rectum to image the prostate.​ Local anesthetic is injected; then a spring-loaded needle takes 10-12 thin tissue cores from different prostate areas, each causing a brief sting (10-20 minutes total).

• Other tests for full evaluation after biopsy confirms cancer cells:
  • PSMA PET-CT scan, increasingly standard, uses a tracer targeting prostate cancer cells for highly sensitive detection of spread to nodes, bones, or elsewhere.​
  • Genetic or molecular tests on biopsy tissue (e.g., Decipher, Oncotype DX) predict aggressiveness and response to therapies.​
  • Results combine with PSA, Gleason score, and clinical exam into a risk group (low to very high) for personalized planning.

 

Inform yourself!

You find information on different websites and here in your support group. Do this BEFORE seeing your urologist so you better understand what he will discuss with you.

When you see your urologist, prepare a list of questions (support group can help!). You should be offered several treatment options. Don't decide right away! Take notes!

 

American Cancer Society study from Sept. 2, 2025:

Prostate cancer is the most common cancer diagnosis among men in the U.S., accounting for  30% of male cancers in 2025, and is the second leading cancer death in men behind lung cancer. This year, ACS estimates there will be 313,780 new cases of prostate cancer and 35,770 deaths. For the report, researchers analyzed population-based cancer incidence data through 2021 and mortality data through 2023 collected by the National Cancer Institute and the Centers for Disease Control and Prevention.

According to study authors, distant‐stage disease is increasing in men of every age, including by nearly 3% per year in those younger than 55 years and 6% per year in men 55 years and older. The five-year relative survival rate for distant-stage prostate cancer is only 38%, but approaches 100% for earlier-stage diagnoses.

 

Discuss your options!

This is maybe the most important step: decide which treatment is best for you.

 

Treatment depends on cancer grade, stage, age, and health, with options including:

• Active surveillance for low-risk cases (regular PSA/MRI monitoring without immediate intervention).​
• Surgery (prostatectomy, often robotic) to remove the prostate.​
• Radiation therapy, hormone therapy, or focal therapies like cryotherapy/HIFU.​

Discuss your exact PSA value, Gleason score, trends, age, and symptoms with a urologist for personalized next steps, as overtreatment risks exist. Ask your doctor about side-effect of each treatment option. If he brushes you off - find a new doctor.

 

Discuss your options also with your partner and maybe with your support group.

 

You don't want to say later: "If he would have told me what I experience now..."

 

Decide your treatment!

Make sure that you fully understand the treatment and side effects - short term AND long term! Understand what options you have if cancer returns!

You may want to check different treatment center/doctors.

Whenever you decide - stick with it. You found the best treatment FOR YOU!

 

 

Questions or comments? Enter below for our blog: