Routine annual screening for prostate cancer consists of a physical examination with a digital rectal examination (DRE) and a prostate-specific antigen (PSA) blood test. During the DRE, the physician feels the prostate to determine if it is enlarged or if any lumps are present. The PSA blood test is an additional diagnostic tool that can detect cancers not found during the physical examination. PSA is a substance that is found in the blood of all men after maturity. In men with prostate cancer, PSA levels are typically elevated. An elevated PSA does not necessarily mean that you have prostate cancer, but it does signal to your physician that further testing is necessary.

Men with palpable lumps or elevated PSA levels may proceed to an ultrasound scan as the next step. If the ultrasound shows a suspicious nodule, your urologist will want to perform a core biopsy - an outpatient procedure in which tissue specimens are obtained from several different areas of the prostate. The definitive diagnosis of prostate cancer is made by microscopic evaluation of these tissue specimens by highly trained pathologists. Pathologists also will assign a Gleason score, which predicts how aggressively the cancer will grow.

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In order to devise the best treatment plan, your physician will need to "stage" your prostate cancer -- or determine how far the tumor has spread -- based on information gathered from the DRE, PSA, ultrasound, core biopsy, and any other tests that might have been ordered. Prostate cancer staging is based on the TNM classification system, which assesses the extent of the primary tumor, lymph node involvement, and any distant metastases. A detailed discussion of the various stages of pancreatic cancer and the appropriate treatment options for each can be found at: http://www.cancer.gov/cancertopics/types/prostate.