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How Doctors Find Metastatic Prostate Cancer

When you are diagnosed with prostate cancer, your doctor will order tests such as:

  • X-rays
  • CT scans
  • MRI scans

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

If you have symptoms such as bone pain and bone breaks for no reason, your doctor may order a bone scan. It can show if you have metastatic cancer in your 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 made by the prostate gland. 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 you’ve had your prostate surgically removed, your 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 a higher than normal PSA level. On average, 8 years pass from the time a man is first diagnosed with prostate cancer to the discovery that it has become metastatic. If you have had prostate cancer, work with your doctor to check your risk and set a schedule for routine PSA checks.