A rectal examination can check whether the prostate has a normal shape. Prostate tumors can cause an irregular shape of the prostate. Abnormally enlarged lymph nodes can also be felt in this way or possibly by palpating the abdominal cavity.
Blood tests can indicate anemia, excess white blood cells, calcium and signs of bone breakdown.
By analyzing urine, abnormal cells can be detected as well as the presence of infection.
By taking radiographic lung photos from different angles, it is possible to detect (if sufficiently large) whether lung metastases are present, enlargement of the lymph nodes at the level of the sternum or in rare cases metastases to the ribs or the shoulder bone.
Radiographic images of the abdominal cavity can show an enlarged prostate and / or enlarged lymph nodes and possibly abnormalities on the edges of surrounding bones.
If there is a suspicion of metastases to the bone, bone scintigraphy can be used to more accurately determine its location.
Contrast matter in the urethra can also be used to check whether there are irregularities in the prostate (however, it cannot be ruled out whether it is an inflammation or tumor).
Ultrasound of the abdominal cavity can be useful to further assess the prostate, as well as the urethra, bladder, local lymph nodes and other organs in the abdominal cavity.
Taking tissue samples is the gold standard for the diagnosis of prostate tumors, but a definitive diagnosis can also be obtained through the aspiration of cells and their examination (cytology).
This can be achieved in several ways, including ejaculation, insertion of a catheter that scrapes cells away, massage of the prostate, ultrasound-guided aspiration of cells through a needle, imprints obtained during surgery. When taking samples through the skin or intestine, there is a risk that this will cause bleeding, but also that the tumor can spread on the path of the needle. In prostate tumors, no tissue sample needs to be taken to determine the tumor grade because the impact of the tumor grade on the prognosis is unclear.