5 methods to screen for prostate cancer

Dr. Ly Minh Hoang, Center for Urology – Nephrology – Andrology, Tam Anh General Hospital, Ho Chi Minh City, said that prostate cancer often has no symptoms in the early stages, so regular screening can help detect it early, increasing the chance of curing the disease. The goal is to identify the disease in the localized stage, when the tumor has not invaded beyond the capsule or metastasized far.

According to Dr. Hoang, current screening is very simple, non-invasive, and highly accurate. Based on age, family factors and symptoms related to the urinary tract, the doctor prescribes appropriate screening methods.

Prostate-specific antigen (PSA) test

This is the most important and popular screening method today. PSA is a protein produced by cells of the prostate. When the prostate has problems such as inflammation, hypertrophy or malignant tumors, PSA levels in the blood will increase. If the PSA index is above 4 ng/mL, the patient is in the risk group and needs more in-depth tests.

Dr. Hoang noted that an increased PSA index does not mean cancer, but is the earliest indicator for continued monitoring and differential diagnosis.

Rectal examination

Examining the surface of the prostate through the rectum helps evaluate size, hardness and check for any hard nodules, nodules or abnormal areas. This method can sometimes detect tumors in men with normal PSA levels. Combining PSA testing and rectal examination significantly increases the rate of early-stage disease detection.

Prostate ultrasound

Transanal (rectal) ultrasound method helps doctors observe and evaluate prostate size, detect benign hypertrophy, inflammatory foci or local tumors. However, in the initial stage, cancerous lesions are often very small in size or have tissue density that is difficult to distinguish, making it difficult for ultrasound to confirm whether the lesion is benign or malignant. Therefore, this method is often used as an supporting tool for initial assessment, identifying benign lesions such as prostatitis, prostate abscess… or guiding the needle puncture location during biopsy.

Magnetic resonance imaging (MRI)

In case the patient is at high risk of prostate cancer, the doctor will prescribe a magnetic resonance imaging (MRI) for in-depth evaluation. Detailed MRI images allow clear visualization of the internal structures of the prostate, determining the location and characteristics of suspected areas of damage. Based on the PI-RADS (Prostate Imaging Data and Reporting System) score, radiologists classify the risk level of the tumor on a scale of one to five.

If the MRI results show a highly suspicious area, your doctor may recommend a targeted biopsy. This method helps to accurately sample tissue at the damaged area, avoiding unnecessary invasive interventions for low-risk patients.

MRI images also play an important role in guiding the biopsy needle and assessing the level of tumor invasion, helping doctors plan optimal treatment if the tumor is malignant.

Prostate biopsy

If the results of the PSA test and diagnostic imaging show a high risk, a biopsy is the final step to confirm the disease. The doctor uses a small needle to take tissue samples from the prostate and examine them under a microscope to determine whether there are cancer cells.

Dr. Hoang recommends that men aged 50 and older should be screened for prostate cancer once a year. People with a family history (father or brother with the disease) should be screened from age 40 or 45 to detect abnormalities early and intervene promptly.