Referral for further tests
If your PSA level is too high or your prostate gland feels abnormal, your GP should refer you to a Urologist (urinary specialist) who may recommend a transrectal ultrasound scan (TRUS). During this procedure, samples of tissue can be taken from the prostate for analysis. If cancer is diagnosed, its severity is determined by the Pathologist, who will be able to give it a score with a maximum of 10 (this is the socalled Gleason score, which is vital information and should be shared with you).
Most prostate cancers have a Gleason score of 6, i.e. moderately aggressive. Higher scores indicate more aggressive cancer, with a score of 10 being the highest. You may need to have further scans such as a CT, MRI or bone scan to determine the stage of your cancer as accurately as possible, i.e. whether the disease has spread to other sites in your body, particularly to the bones. This information will help you and your doctor to decide which treatment would be most appropriate.