The digital rectal examination , a simple procedure, can help the doctor detect the cancer and judge whether the cancer is confined to the prostate or whether it may have spread to the tissues around the prostate. The prostate is an internal organ so the physician cannot look at it directly. Because it lies in front of the rectum, however, the doctor can feel the prostate by inserting a gloved, lubricated finger into the rectum. The PSA test is sometimes difficult to interpret, however, because PSA is produced by both normal and malignant prostate cells. The test often is helpful though because, in general, the higher the PSA level, the greater the chance that the cancer has spread beyond the prostate.
Transrectal ultrasonography is a safe and easy way to see the prostate gland.
Needle biopsy of the prostate is usually performed under ultrasound guidance. A prostate biopsy analysis of tissue removed by biopsy gives important information about the cancer. The tumor grade is determined by examining the tissue under a microscope to measure the amount of disorganization of cells. A Gleason grade, which ranges from 2 to 10, usually is used to indicate the tumor's growth rate. Generally, the lower the grade, the slower the cancer grows.