Most of these patients will be asymptomatic or have difficulty urinating. If the cancer has spread, patients may present with bladder outlet obstruction or bone pain from spread of the cancer to the bones. Patients also may present with renal failure from obstruction of the urethra. Digital rectal exam is the gold standard for detection of prostate cancer. Fifty percent of palpable nodules will be found to contain cancer.
Transrectal ultrasonography is used for the evaluation of a prostate nodule.
It is also used to better define what area to biopsy. This procedure involves inserting a probe into the rectum and obtaining an ultrasound of the prostate gland. The biopsy can then be directed at any abnormalities on the resulting picture. The American Cancer Society recommends a yearly digital rectal exam starting at age 40. The PSA test measures a protein in the blood that increases with the development of prostate cancer.