Prostate Cancer Diagnosis in New York, NY
Prostate cancer is highly curable when it is diagnosed early. Today’s diagnostic tools make it possible to find cancer sooner, measure how aggressive it is with greater precision, and avoid unnecessary biopsies in many men. At Prostate Cancer 911, Dr. David Samadi combines PSA testing, physical examination, advanced MRI imaging, targeted biopsy, and genomic testing to give every patient an accurate diagnosis and a clear path forward.
How Prostate Cancer Is Diagnosed
Diagnosis usually follows a step-by-step process. It begins with screening tests that look for warning signs, continues with imaging when results are abnormal, and is confirmed only with a biopsy that examines prostate tissue under a microscope.
The PSA Test
What Is the PSA Test?
Prostate-specific antigen (PSA) is a protein made by the prostate. A simple blood test measures how much PSA is in your bloodstream. Higher levels can signal prostate cancer, but they can also be caused by an enlarged prostate, prostatitis, recent ejaculation, cycling, or a recent urologic procedure. That is why Dr. Samadi looks at your PSA trend over time, PSA density, and free PSA rather than a single number. Learn more on our elevated PSA page.
When Should I Have a PSA Test?
Average-risk men should discuss screening around age 50. African American men and men with a family history should begin at 45, and men with multiple affected relatives or known BRCA mutations may start at 40. Establishing a baseline PSA in your 40s can also help track changes later.
Digital Rectal Exam (DRE)
During a DRE, the doctor gently feels the back of the prostate through the rectal wall to check for lumps, hard areas, or asymmetry. The exam takes less than a minute and can detect some cancers that do not raise PSA.
Advanced Imaging: Prostate MRI
Multiparametric MRI creates detailed images of the prostate and highlights areas that look suspicious, scored using the PI-RADS system. An MRI before biopsy can help some men avoid an unnecessary biopsy and helps target the most concerning areas when one is needed.
Prostate Biopsy
A biopsy is the only way to confirm prostate cancer. Small tissue samples are taken from the prostate with a thin needle and examined by a pathologist, who assigns a Gleason score and Grade Group describing how aggressive the cancer is.
TRUS-Guided Needle Biopsy
A traditional transrectal ultrasound (TRUS) biopsy uses ultrasound to guide the needle and samples several regions of the prostate in a systematic pattern. While effective, it can miss some tumors and may detect low-risk cancers that would never cause harm.
MRI Fusion Biopsy
An MRI fusion biopsy overlays MRI images onto real-time ultrasound so the needle can be aimed directly at suspicious areas. This approach improves detection of clinically significant cancers and reduces overdiagnosis of insignificant ones.
Imaging to Check for Spread
CT scan: Shows whether cancer has reached lymph nodes or other organs.
Bone scan: Detects spread to the bones in higher-risk cases.
PSMA PET scan: A newer, highly sensitive scan that can locate small deposits of prostate cancer anywhere in the body.
Biomarker and Genomic Tests
Additional tests help refine risk and guide decisions about biopsy and treatment:
- Prostate Health Index (PHI): Combines total, free, and [-2]proPSA to better estimate the likelihood of significant cancer.
- 4Kscore: A blood test that predicts the risk of aggressive prostate cancer before biopsy.
- Urine tests such as PCA3 and SelectMDx: Measure genetic markers in urine after a prostate exam.
- Tissue genomic tests such as Decipher, Oncotype DX, and Prolaris: Analyze biopsy tissue to predict how a cancer is likely to behave, helping men decide between active surveillance and treatment.
After Your Diagnosis
Once cancer is confirmed, Dr. Samadi uses your Gleason score, PSA, imaging, and exam findings to determine the stage. Learn what these results mean on our staging and survival rates page, then explore your treatment options. To schedule testing or a second opinion, call Prostate Cancer 911 at (212) 365-5000.
Related Care and Resources at Prostate Cancer 911
Prostate Cancer Diagnosis FAQs
What PSA level is considered high?
Many labs use 4.0 ng/mL as a general cutoff, but there is no single normal value. Age, prostate size, and how quickly PSA is rising all matter, so a urologist should interpret your result.
Does a high PSA mean I have prostate cancer?
Not necessarily. Enlarged prostate, prostatitis, infection, and recent ejaculation can all raise PSA. Learn more on our elevated PSA page.
Do I need an MRI before a prostate biopsy?
An MRI before biopsy is increasingly recommended. It can identify suspicious areas, help target the biopsy, and in some cases help men avoid an unnecessary biopsy.
What is the difference between a standard and MRI fusion biopsy?
A standard biopsy samples the prostate in a systematic pattern, while an MRI fusion biopsy uses MRI images to target suspicious areas directly, improving detection of significant cancers.
Is a prostate biopsy painful?
Biopsies are performed with local anesthesia or sedation, and most men experience only mild discomfort. Some blood in the urine, stool, or semen afterward is common and temporary.
What is a PSMA PET scan?
A PSMA PET scan is a highly sensitive imaging test that detects prostate cancer cells throughout the body. It is used to check for spread in higher-risk cases or when PSA rises after treatment.
Can I get a second opinion on my biopsy results?
Yes. Dr. Samadi frequently reviews outside pathology and imaging. Call (212) 365-5000 or request an appointment.
Schedule Your Consultation With NYC’s Leading Urologist
Take control of your health today. Whether you are seeking a second opinion or experiencing symptoms like hematuria, Dr. David Samadi and the team at Prostate Cancer 911 are here to provide world-class care in Midtown Manhattan.
Request an AppointmentOffice Location: 485 Madison Ave, 21st Floor, New York, NY 10022
Phone: (212) 365-5000