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How Metastatic Prostate Cancer Is Found

If you've been diagnosed with prostate cancer, your doctor will order additional tests such as:

  • X-rays
  • CT scans
  • MRI scans

These tests may focus on your skeleton and abdominal and pelvic areas. That way doctors can check for signs of the cancer's spread.

If you have symptoms such as bone pain and fractures for no reason, your doctor may order a bone scan. The bone scan can show if you have metastatic cancer in the bones.

Your doctor will also ask for blood tests, including a check of PSA levels, to look for other signs of the cancer's progression.

PSA is a protein normally made by the prostate gland. It can be measured with a simple blood test. A rise in PSA is one of the first signs of the progression of prostate cancer. PSA levels can be high without there being cancer, such as if you have an enlarged prostate or a prostate infection.

But if you've been treated, especially if your prostate has been surgically removed, PSA levels should become undetectable. The presence of any PSA after surgery is a concern. Any rise in PSA after radiation or hormone treatment suggests the possibility of the cancer spreading. In that case, the doctor will order the same tests used to diagnose the original cancer, including a CT scan, MRI, or bone scan.

Though very rare, it's possible to have metastatic prostate cancer without an elevated PSA. And it's possible to have an elevated PSA without cancer.

The average length of time from original diagnosis to the discovery of metastatic cancer is eight years. If you have had prostate cancer, work with your doctor to determine your risk and determine a schedule for routine PSA checks.