Getting diagnosed with prostate cancer
You usually have a number of tests to check for prostate cancer. These include:
a digital rectal examination
a PSA blood test
scans
taking a sample of your prostate gland- this is called a biopsy
Most people start by seeing their GP. They can do some tests to help them decide whether you need a referral to a specialist. The tests your GP might arrange include:
an examination of your prostate gland (digital rectal examination)
a prostate specific antigen (PSA) blood test
Your doctor checks your prostate gland for abnormal signs such as lumps or hard areas. This is also called digital rectal examination (DRE).
To examine your prostate, the doctor puts a gloved finger into your back passage (rectum).
Find out what happens during a digital rectal examination
The PSA test measures the amount of prostate specific antigen (PSA) in your blood. PSA it’s a protein made by both normal and cancerous prostate cells.
It’s normal for all men to have some PSA in their blood. But a PSA level higher than what would be expected for someone of your age can be a sign of prostate cancer.
Read more about a PSA blood test and how you have one
Depending on the results of your tests, your GP might refer you to a specialist. You usually see a urologist. This is a doctor who specialises in treating problems of the urinary tract system such as the prostate, bladder and kidneys.
Your specialist usually does more tests. These might include:
an MRI scan (MRI)
biopsy
CT scan
bone scan
PET scan
The first scan your specialist does is an MRI scan. MRI stands for magnetic resonance imaging. It uses magnetism and radio waves to take pictures of the inside of the body.
An MRI scan helps your doctor:
check for any abnormality in the prostate gland
decide whether you need a biopsy
guide where to take the biopsy from
look at the local and bones around your pelvis to make sure they are normal
Your doctor might not do an MRI if you're unwell or not likely to be able to have a biopsy or future treatment.
For prostate cancer you usually have a type of MRI scan called a multiparametric MRI scan (mpMRI). Some people may have a type of MRI scan called biparametric MRI instead. A mpMRI scan produces a more detailed picture of your prostate gland than a standard MRI scan.
A doctor who specialises in imaging scans gives the MRI scan a score based on the results. This score helps your doctor decide on the next step and whether you need to have a biopsy of your prostate gland.
This score is called the Likert or PI-RAD system. It estimates the risk that an area seen on the MRI scan may be a significant cancer or not. Significant cancer means the cancer might need treatment. The score is from 1 to 5.
Likert score | What this means |
|---|---|
1 | It’s highly unlikely there is prostate cancer present |
2 | It’s unlikely there is prostate cancer present |
3 | It’s difficult to tell from the scan if a prostate cancer is present or not |
4 | It’s likely there is prostate cancer present |
5 | It’s very likely there is prostate cancer present |
Your doctor may not recommend a biopsy if you have a low Likert score. But you can still have one if you want to. Your doctor will explain the possible benefits and risks of having a biopsy.
When recommending whether you need a biopsy or not, your doctor also looks at other factors. These include:
your age
the size of your prostate and the corrected PSA for its size - this is called the PSA density
any other health conditions that you might have
how well you’d cope with prostate cancer treatment and if it would benefit you, taking your life expectancy into account
They might decide not to recommend a biopsy if you're unwell or not likely to be able to have treatment.
If you don't have a biopsy, your doctor may recommend monitoring your PSA level. They will recommend what your PSA level should be. You are usually discharged back to your GP to be monitored. Your GP can refer you back if the PSA levels go up.
This result on its own doesn’t mean that you definitely have prostate cancer. But it’s more likely that you do. Your doctor is likely to recommend for you to have a biopsy.
The MRI scan can also help doctors know where to take the biopsy from. You usually have tissue samples taken from the suspected area of cancer and also from the rest of the prostate. Doctors call these targeted biopsies and systematic biopsies. This is because not all cancers can be seen on an MRI scan.
During a biopsy, your doctor takes samples of tissue from your prostate. They send the samples to a laboratory and a doctor looks at them under a microscope to check for cancer.
There are 2 main ways to have a prostate biopsy:
transperineal biopsy - the needle goes through the
transrectal ultrasound scan (TRUS) guided biopsy - the needle goes through the wall of the
Most hospitals in the UK now use transperineal biopsy to diagnose prostate cancer.
Your doctor puts a needle into the prostate through the skin between the testicles and the back passage (rectum). This is the perineum. They then take a number of samples from the prostate to examine under a microscope.
You usually have this biopsy under . Or you might have it in the operating theatre under a general anaesthetic. This is when you are asleep and don’t feel anything.
Read about transperineal biopsies
Your doctor takes a series of small tissue samples from the prostate to examine under a microscope. You have the biopsy through the back passage (rectum) using a transrectal .
A TRUS guided biopsy can be uncomfortable. You usually have a to numb the area and reduce any pain.
Find out more about having a TRUS guided biopsy
A specialist doctor called a pathologist looks at the prostate samples under a microscope. The results usually take about 2 to 4 weeks.
You might have a negative biopsy. This means that no cancer cells were found. Your doctor might recommend another biopsy even if the first was negative. They'll discuss this with you. This is because in some cases biopsies can miss cancer.
A positive biopsy means that they have found cancer cells. A pathologist then grades each sample of prostate cancer cells based on how quickly they are likely to grow or how aggressive the cells look. You may hear this called the:
Grade Group
Gleason score
The Grade Group has now replaced the Gleason grade as doctors think the Grade Group is a more accurate way to grade prostate cancer cells. We have included the Gleason score because people still ask us about this.
Doctors now use the Grade Group and other information to divide prostate cancer into 5 groups. This is called the Cambridge Prognostic Group (CPG). It is for prostate cancer that has not spread to other parts of the body.
It can be difficult to understand what the Grade Group and CPG mean in your situation. We have more information about this, and you can ask your doctor and specialist nurse if you have any questions.
Find out more about the Grade Groups and CPG for prostate cancer
The NHS cancer alliance website has information about Grade Groups and the CPG. It is for people with prostate cancer that has not spread. It also has information about the National Institute for Health and Clinical Excellence (NICE) treatment recommendations for different groups.
Visit the NHS cancer alliance website
Your tests results might show that the cancer has already spread when you are diagnosed. Doctors call this metastatic prostate cancer. The way doctors manage and treat metastatic prostate cancer is different.
If you have a biopsy that shows that you have cancer cells in your prostate, then you may have more tests to work out where and how big the cancer is. This is called staging the cancer.
The tests you have next depend on the type of cancer you have. The tests you might have include:
CT scan
bone scan
PET scan
CT (or CAT) scan stands for computed (axial) tomography. It is a test that uses x-rays and a computer to create detailed pictures of the inside of your body.
You might have a CT scan to find out whether the cancer is in the prostate only or whether it has spread to other parts of your body.
Read more about CT scans in our general cancer tests section
A bone scan shows up changes or abnormalities in the bones. You might have a bone scan to find out if prostate cancer has spread to the bones.
Find out more about bone scans in our general tests and scans information
A PET scan is a test that creates 3 dimensional (3D) pictures of the inside of your body. PET stands for positron emission tomography. It uses a mildly radioactive liquid called a radioactive tracer. You might have a PET scan to find out if your cancer has spread.
Read more about PET scans in our general tests section
The tests you have helps your doctor find out if you have prostate cancer and how far it has grown. This is the stage of the cancer.
Read about the stages of prostate cancer
This is important because doctors recommend your treatment according to the stage of the cancer.
Find out about the treatments of prostate cancer
Coping with a diagnosis of prostate cancer can be difficult. There is help and support available to help you and your family.
Read about how to access support and information when coping with prostate cancer
Last reviewed: 14 May 2025
Next review due: 14 May 2028
Prostate cancer is cancer of the prostate gland. The prostate gland is part of the male reproductive system, and is at the base of the bladder.
Prostate cancer doesn't usually cause any symptoms in the early stages.
The PSA test is a blood test that measures the amount of prostate specific antigen (PSA) in your blood. It can help to diagnose prostate cancer.
Doctors use Grade Groups and other information to divide prostate cancer into 5 groups called the the Cambridge Prognostic Group (CPG). The stage tells you the size of the cancer and whether it has spread.
You may have a choice of treatments such as surgery or radiotherapy. Or your doctor might suggest that they monitor your cancer instead of treatment straight away.
Prostate cancer is cancer that starts in the prostate gland. The prostate gland is found at the base of the bladder and is about the size of a walnut.
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