You may also have one or more of the following tests:

Digital rectal examination (DRE)

The doctor places a gloved finger in the rectum to feel the prostate gland. They will note whether it is enlarged, and what it feels like. A cancerous prostate tends to feel harder than a non-cancerous one.

Blood test (PSA test)

This is to check for a substance called prostate-specific antigen (PSA). A high level of PSA may be a sign of cancer, but the test is not foolproof. For example, some non-cancerous conditions can also raise your PSA, and around one in 10 prostate cancer patients have a normal PSA level.

If your GP thinks you may have cancer they will send you to see a specialist doctor (a urologist) at a nearby hospital. There are NHS cancer referral guidelines to help GPs decide who may need to see a specialist, and how quickly.

At the hospital you will have these tests:

Transrectal ultrasound

Your doctor will need to take some samples of tissue (biopsies) to be examined under a microscope.

They will use a fine needle to take the samples from the prostate. First, an ultrasound probe with a needle inside it is put into the rectum. The probe makes a picture on a computer screen, which the doctor uses to guide the needle to exactly the right place and measure the size of the prostate. Most men say this test is unpleasant, but normally it isn’t too painful.

A doctor in the laboratory (a pathologist) will look at your cells to see whether you have cancer. If you do, the cancer will be given a Gleason score of between Gl 2 and Gl 10.

The Gleason score tells your doctor how aggressive the cancer is – in other words, how fast it might grow, and how much it might spread. The lower the score the better – but remember, no one can know for sure how your particular cancer will behave.

Repeat PSA blood test and DRE

The hospital doctor will check your PSA level again and carry out a further DRE.

If there is a chance your cancer has spread, you may also need to have an MRI scan or CT scan and possibly a bone scan as well.

Magnetic resonance imaging (MR or MRI scan)

The MRI scan uses a magnet and radio waves to create a picture of the inside of the body. You lie on a couch inside a long chamber while the pictures are taken. The scan helps the doctor to see how far the cancer has spread.

Bone scan

This is a test to look for any areas of bone where there is a lot of activity.

The activity could be bone breaking down, or bone repairing itself. There are several possible reasons for bone activity. Cancer is one of them, but other reasons include arthritis, fractures and bone infections, so the test results need to be carefully interpreted.

For the test, a mildly radioactive substance is injected into a vein in the arm. Then a large machine called a gamma camera takes a scan of the body. The radioactive substance helps to show up any active areas of bone – these are called hot spots.