test results suspicious? here are the next steps
Understanding the Diagnosis Process
If your PSA (Prostate-Specific Antigen) test or Digital Rectal Exam (DRE) shows something unusual, it’s natural to feel anxious. But remember — an abnormal result does not automatically mean you have cancer.
Many men with elevated PSA levels or an enlarged prostate do not have prostate cancer. However, further testing helps your doctor confirm what’s going on and ensures you get the right care early — when treatment is most effective.
Diagnosis is about clarity, not confirmation of fear. It helps separate what’s serious from what’s not.
01.
When Screening Results Suggest a Problem
If your PSA level is higher than normal or your DRE reveals a lump or irregularity, your doctor may:
Repeat the PSA test after a few weeks (to confirm it’s not a temporary rise due to infection, exercise, or other causes).
Order imaging or specialized scans to get a clearer picture of the prostate.
Recommend a prostate biopsy to confirm whether cancer cells are present.
Each of these steps is part of a careful, guided process — you’ll never be rushed into treatment without proper evidence and consultation.
02.
Step-by-Step: What Happens Next
1. Repeat or Follow-Up PSA Test
Sometimes PSA levels go up temporarily due to conditions like prostatitis (inflammation) or even after heavy exercise or sexual activity.
A follow-up test after a few weeks can show whether the PSA is staying high, increasing, or returning to normal.
Doctors also look at PSA velocity (how fast it rises) and PSA density (compared to prostate size).
If PSA remains elevated, your doctor will move to imaging or biopsy to investigate further.
2. Imaging Tests
Modern imaging helps doctors see inside the prostate without surgery.
Multiparametric MRI (mpMRI):
A detailed scan that helps identify suspicious areas inside the prostate before a biopsy. It can also help avoid unnecessary biopsies.Transrectal Ultrasound (TRUS):
A quick imaging test that uses sound waves to create a picture of the prostate and guide biopsy needles accurately if needed.
These scans help determine whether a biopsy is necessary and, if cancer is found, how aggressive it might be.
3. Prostate Biopsy
If imaging suggests abnormal tissue, your doctor will recommend a prostate biopsy — the only way to confirm prostate cancer.
A small, thin needle collects tiny samples of prostate tissue, usually 10–12 samples from different areas.
It’s done under local anaesthesia and typically takes 10–15 minutes.
The samples are sent to a lab where a pathologist looks for cancer cells.
Results usually arrive within one to two weeks.
If cancer is present, the report will include a Gleason Score, which indicates how aggressive the cancer is (higher scores mean faster-growing cancers).
4. Additional Tests (If Cancer Is Found)
If the biopsy confirms cancer, your doctor may recommend further tests to determine the stage — how far the cancer has spread, if at all.
These may include:
CT or MRI scans of the pelvis
Bone scan (to check if cancer has spread to bones)
PET scan (in select cases, for detailed mapping)
These results help create a personalized treatment plan that fits your condition and overall health.
03.
Understanding the Results
| Result | What It Means | Next Steps |
|---|---|---|
| PSA slightly elevated, biopsy negative | No cancer, but continued monitoring needed | Repeat PSA every 6–12 months |
| Biopsy shows low-grade cancer | Cancer is slow-growing, may not need immediate treatment | “Active surveillance” (regular check-ups) |
| Biopsy shows moderate to high-grade cancer | Cancer is more active and may spread | Discuss treatment options like surgery, radiation, or hormone therapy |
Good to know: Most prostate cancers found early are localized (contained within the gland) and highly treatable.
04.
Next Steps
If you receive a confirmed diagnosis, take things one step at a time:
1. Talk to Your Doctor Thoroughly
Ask:
- What stage is my cancer?
- What are my treatment options?
- What are the side effects of each treatment?
- Do I need treatment right away or can I monitor it safely?
2. Consider a Second Opinion
It’s completely normal — and often encouraged — to seek another doctor’s opinion, especially from a urologist or oncologist specializing in prostate cancer.
3. Involve Your Family
Let your loved ones be part of your journey. Family support makes medical decisions easier and helps with emotional well-being.
4. Focus on Your Options, Not Fears
Prostate cancer is one of the most manageable cancers, especially when detected early.
Treatment success rates are over 95% for early-stage cases.
Even when treatment is needed, side effects are often manageable, and recovery is strong.
