There are several tests that can to be done to confirm the diagnosis and to classify the stage of the disease. The doctor may proceed with one or more of the following tests:

DRE (Digital Rectal Examination)

• DRE is a quick exam for checking the prostate. This is usually the first step in diagnosing prostate cancer. The prostate is examined via the rectum. A normal feeling prostate does not rule out cancer as in the early stage the growth will not be palpable. In more advanced tumor a hard lump can be felt. However the final confirmation of cancer can only be made after a biopsy.

PSA (Prostate Specific Antigen)

• The prostate specific antigen (PSA) is a substance produced in the prostate gland and a small amount of the antigen is released to the blood stream. The PSA level in the blood can be measured and is used as a screening test. A raised is not diagnostic of prostate cancer as other benign conditions like BPH or prostatitis can also give rise to a high PSA.

TRUS (Transrectal Ultrasound)

• TRUS or also known as transrectal ultrasound provides images of the prostate and surrounding tissue and allows the physician to examine the gland for abnormalities. TRUS is usually not recommended as a routine test by itself to detect prostate cancer because it doesn't often show early cancer. Instead, it is most commonly used during a prostate biopsy.

Biopsy

• Prostate biopsy has been recommended when the PSA (Prostatic Specific Antigen) level gets higher. A prostate gland biopsy is a test to remove small samples of prostate tissue to be examined under a microscope. There are 2 types of procedures, namely transectal biopsy and transperineal biopsy.

1. 1. Transectal biopsy - A procedure in which a sample of tissue is removed from the prostate using a thin needle that is inserted through the rectum and into the prostate. This is done under TRUS guidance
   2. Transperineal biopsy - A procedure in which a sample of tissue is removed from the prostate for examination under a microscope. The sample is removed with a thin needle that is inserted through the skin between the scrotum and rectum and into the prostate. This is done mainly under TRUS guidance.

Updated:: 04/04/2019 []