What is the Most Accurate Test for Prostate Cancer

Several tests are available for prostate cancer. But what is the most accurate test for prostate cancer? Usually, a combination of these tests is conducted to provide an accurate diagnosis of prostate cancer. Prostate cancer tests are generally of two types:

1. Screening tests
2. Diagnostic tests

Cancer screening tests are tests to check for early cancer, usually before the patient develops any symptoms. Screening tests only help learn if the patient is at risk. They cannot diagnose cancer.

Prostate-Specific Antigen (PSA) Blood Test

PSA is a blood test to screen for prostate cancer. Both normal and cancerous cells of the prostate gland produce prostate-specific antigen (PSA), which is a type of protein. A PSA blood test is usually done to measure the levels of this antigen in the blood. When there is a spike in the levels of PSA, it may indicate prostate cancer. This is why it is also known as gold standard test to detect prostate cancer in its early stages. 

However, other conditions like inflammation of the prostate (prostatitis) and benign prostatic hyperplasia (BPH) or prostate enlargement, age, and infections may also cause an increase in the PSA level in the blood. 

Results: 

1. PSA test cannot provide an accurate diagnosis for prostate cancer as there is no fixed PSA reading considered normal or abnormal. This is because the values vary from person to person. 
2. Even though there is no set cut-off point indicating normal or abnormal PSA level, the person is said to be at a higher risk of prostate cancer if their PSA blood test levels are found between 4.0ng/ml to 10ng/ml.  

Further tests may be conducted to assess men with a high prostate cancer risk. These include:

1. Another PSA test is usually done within three months from the first test. This repeated test is done to check if the PSA levels are still high and if a biopsy is needed for diagnosis. During the time between the first PSA blood test and another PSA test, the patient may be given treatment for any infection in the prostate that may be causing a PSA spike.
2. The free-PSA test, this blood test is used to measure the level of a free prostate-specific antigen called free PSA in the blood. PSA that is not bound to any other blood protein is called free PSA or PSA. Test results where the level of free PSA is low in the blood may indicate prostate cancer, which calls for further tests to confirm it. 

Digital rectal examination (DRE) 

1. In digital rectal examination (DRE), the doctor examines the patient for any abnormality in the prostate by feeling it with the help of a finger. 
2. To conduct a digital rectal examination (DRE), the doctor will put a gloved finger after lubricating it into the patient's anus to feel the area and look for any bumps or hardness that might indicate prostate cancer. 

Result: If the doctor feels any lump or hardness, further tests like a biopsy may be prescribed. However, it is essential to know that digital rectal examination does not produce precise results and is hence, not the most accurate test for prostate cancer.

After studying the signs and symptoms, conducting a physical examination, and checking the patient's medical history, a disease or condition is diagnosed with the help of diagnostic prostate cancer tests.

The various diagnostic tests for prostate cancer include the following:

Transrectal Ultrasound (TRUS) 

1. In a transrectal ultrasound (TRUS), a lubrication probe is inserted into the patient's anus. The inserted probe helps capture black-and-white images of the prostate. TRUS helps check for prostate abnormality after a PSA or DRE test while performing a biopsy. 
2. Result: Images of the prostate are formed during a TRUS, which can help view any abnormalities present in the prostate. 
3. Prostate cancer can also be diagnosed with good accuracy using a new type of ultrasound called multiparametric ultrasound (mpUSS). 

Magnetic Resonance Imaging Scan (MRI)

1. In an MRI scan, magnets and radio waves are used to get detailed prostate images. Multiparametric magnetic resonance imaging (mpMRI) is a special kind of MRI scan used to detect, assess, and stage prostate tumours. MRI scans detect prostate cancer with great accuracy. 

Result: An mpMRI shows if there is any cancer present in the prostate, whether it has spread to other parts of the body or is aggressive. 

1. Note: Before undergoing an MRI scan, it is essential to inform the doctor if the patient has any internal device like a pacemaker or an implant, allergies, or a reaction to any scan in the past. 

Biopsy 

1. A biopsy is the most accurate test for prostate cancer. During a biopsy, a small prostate tissue is surgically removed and examined under a microscope to check for cancer cells. 
2. A urologist usually performs a biopsy. Sometimes to diagnose prostate cancer, an MRI fusion biopsy, a combination of an MRI scan with a transrectal ultrasound (TRUS) may also be used. 

The types of biopsies that the doctor may perform are:

1. A transperineal biopsy: In this type of biopsy, under the effect of a general anaesthetic, the needle is inserted into the patient's prostate through the skin present at the back of the scrotum to extract a tissue sample. 
2. A transrectal biopsy: This is performed most commonly. Here, the needle is inserted through the rectal wall (anus) to take out samples of the prostate tissues. 

Result: 

1. A negative biopsy result means no cancer cells were found.
2. A positive result means cancer cells were found in the tissue samples. Based on the Gleason scoring system, the doctor then stages cancer to plan the treatment accordingly.

Prostate health index (PHI)

1. This is a new blood test for prostate cancer approved by the FDA. It is recommended for men after a PSA test shows scores between 4 to 10. But what is this new blood test to screen for prostate cancer?
2. A new blood test for prostate cancer, called Prostate health index (PHI), is a novel approach used as an alternative blood test to screen for prostate cancer. 
3. This new blood test is more accurate at detecting the presence of prostate cancer and how aggressive it is compared to the other tests. Additionally, it also helps avoid unnecessary biopsies.

Result: A PHI score between 0-26.9 indicates a probability of about 10% cancer, whereas a PHI scores greater than 55 indicates a probability of about 50% of cancer found during a biopsy. 

4k score test 

1. 4k score test is another blood test that is found to be an accurate test for determining the risk of aggressive prostate cancers. It works by measuring the levels of four proteins, namely free PSA, total PSA, intact PSA, and kallikrein 2 in the patient's blood. 
2. It has been found to give better results when combined with an MRI scan. 4k score also helps in avoiding the need for unnecessary biopsies. Result: A 4K score above 7.5% may indicate the need for a biopsy.

The most accurate test for diagnosing  prostate cancer among all the existing tests is a prostate biopsy. This is because not only it helps confirm the presence of cancer cells but also the type and grade of the cancer. When a tissue sample is taken through MRI and studied under a microscope it shows the multiple number of cancerous cells. 

Other tests like PSA and DRE do not always result in 100% accuracy and can only be used as preliminary tests to detect prostate cancer.

Important Note

It is essential to remember that all the above mentioned tests are important for accurately diagnosing prostate cancer. Only a single test is not sufficient for diagnosis, and a healthcare provider will have to carry a series of test to diagnose the presence of cancer and determine its stage.

Prostate cancer is a serious condition. Timely diagnosis and treatment is important to provide a good prognosis to the patient. Since the symptoms of prostate cancer take time to appear, periodic screening tests like PSA tests and DREs are advised, especially in men at high risk. 

Although various prostate cancer tests are available, a biopsy is the most accurate test for prostate cancer. New blood tests, including Prostate health index (PHI) and 4K score, are also found to produce results with good accuracy. 

At HexaHealth, our team of highly qualified experts aims to provide the correct diagnosis to the patient and treatment plans and provide you with details about what is the most accurate test for prostate cancer. At HexaHealth, our goal is to provide our patients with the best services that are not only affordable but also of excellent quality. 

We ensure that all our patients are comfortable at all times and are left fully satisfied with our healthcare services.