Prostate Cancer Risk Evaluation

Evaluation of prostate cancer risk continues to be an evolving and important are of urological care.

If men, their families, or their GPs are concerned regarding an individual man’s prostate cancer risk, then there is a number of specific evaluations which can help clarify this risk further.

Most patients seeing a urologist, have had evaluation of their PSA (blood test to measure prostate specific antigen) at some stage. While this test is not perfect, it can give useful information in the overall evaluation of prostate cancer risk. In addition to the absolute level, there are age-reference ranges, and sub-analyses that refine the information available. The change in the PSA over time, called kinetics, also gives important information regarding an individual’s risk.

Evaluation with a Urologist includes a detailed medical history, including of the family history, and a physical examination of the prostate.

Further testing is sometimes required to clarify further the risk of prostate cancer. This can include specific radiology testing, such as multiparametric MRI prostate, CT and bone scans, and less commonly PSMA PET CT scanning.

Definitive diagnosis can be achieved by sampling prostate tissue with a biopsy. This can be performed using ultrasound guidance or CT guidance, with several different technical approaches.

These evaluations provide essential information to guide discussions regarding the most appropriate options for management if disease is detected, or suitable monitoring protocols for the future.