If you have symptoms

If you have symptoms, your GP will ask you about them, how long you have had them, whether they are getting worse over time, and how they are affecting your life. They might ask you to fill out a questionnaire about your symptoms and medical history.  

Your GP will check whether your symptoms could be caused by other health problem, such as diabetes, or by any medicines you’re taking. They will also check whether your symptoms could be caused by your lifestyle.

Fluid diary

Your GP may ask you to keep a diary for a few days to measure how much fluid you are drinking, what type of drinks you are having, how much urine you pass, and how often.  The diary may highlight what could be causing your symptoms and may help your doctor find the best treatment for you.

Urine test

Your GP may ask you for a urine sample to check for blood or infection that could be causing your symptoms.   You may need to give more than one sample. If you have an infection your GP will give you a course of antibiotics.

PSA test

The PSA test is a blood test that measures the total amount of prostate specific antigen (PSA) in your blood. PSA is a protein produced by normal cells in the prostate and also by prostate cancer cells.

It’s normal to have a small amount of PSA in your blood, and the amount rises as you get older. A raised PSA may show that you have a problem with your prostate, but not necessarily cancer. This is because a number of things can cause your PSA level to rise – including age, an enlarged prostate, infection, vigorous exercise and recent ejaculation, as well as prostate cancer.

Diagram of where the prostate is

A PSA test alone can’t tell you whether you have prostate cancer. Your GP will need to look at your PSA level together with other test results. They will also ask you about things which might make you more likely to get prostate cancer – for example, your age, family history and your ethnicity. This will help them decide if you need to see a hospital specialist for more tests.

You can have a PSA test at your GP surgery. There are pros and cons to having a PSA test. Your GP should explain these to you and discuss any questions you may have before you decide whether to have it.

Getting the results

It can take around a week to get the PSA test results. If your PSA level is within the normal range or lower then you may not need any further tests. Some men with a normal PSA level can have prostate cancer, so your GP might advise you to have another PSA test in the future.

A very high PSA level (for example, in the hundreds or thousands) normally means that a man has prostate cancer. If your PSA level is only slightly above the normal range for your age, then your doctor can’t tell as much from the result and would normally need to do other tests to help find out if there is a problem.

Read more about the PSA test.

Digital rectal examination (DRE)

A common way of helping to diagnose a prostate problem is for your doctor or nurse to feel the prostate gland through the wall of the back passage (rectum). This is called a digital rectal examination (DRE).

During a DRE, the doctor or nurse will ask you to lie on your side on an examination table, with your knees brought up towards your chest. The doctor or nurse will slide their finger gently into your back passage. They’ll wear gloves and put some gel on their finger to make it more comfortable.

They’ll feel your prostate for any hard or irregular areas and to get an idea of its size. This may be uncomfortable, and some men find it slightly painful. Some men find it embarrassing but the test will be over quickly.

diagram showing the doctor or nurse feeling the prostate through the back passage

If the prostate gland is larger than expected for your age this could be a sign of an enlarged prostate. A prostate gland with hard, bumpy areas may suggest prostate cancer.

If your DRE shows anything unusual, you might be referred to a hospital specialist. It’s not a completely accurate test – a man with prostate cancer might have a prostate that feels normal.

If you have a DRE, your doctor or nurse might suggest waiting a week before having a PSA test. This is because having a DRE just before a PSA test could slightly raise your PSA level.

Having someone examine you from the rear isn’t great but it’s only a few seconds of discomfort.

- A personal experience

What happens next?

If your GP thinks you might need further tests to work out if you have a prostate problem, they will refer you to see a hospital specialist, usually a urologist.

The specialist might repeat some of the tests you were given by your GP. Depending on the results, they might offer you another PSA test in the near future to check that your PSA is not rising.

Read about what happens at the hospital.

Worried about going to the GP?

It is natural to feel worried or embarrassed about having tests and check-ups. But don’t let that stop you going to your GP. Remember, the tests give your GP the best idea about whether you have a problem that needs treating. If you would to see a male GP, ask for one when you make the appointment.

You can also talk things through with our Specialist Nurses.

What if your GP won't give you a PSA test?

If you're over 50 and have discussed the pros and cons of the PSA test with your GP or practice nurse, and decide that you want to have one, they should give you a PSA test. But we know that some men have trouble getting the test. If this happens to you, read our information on what to do next.


Updated: February 2014 | Due for Review: February 2016

  • List of references  

    • Burford D, Kirby M, Austoker J. Prostate Cancer Risk Management Programme information for primary care; PSA testing in asymptomatic men. Evidence document. NHS Cancer Screening Programmes [Internet]. 2010.
    • National Institute for Health and Clinical Excellence. Lower urinary tract symptoms. The management of lower urinary tract symptoms in men. 2010.
    • National Institute for Health and Care Excellence. Prostate Cancer: diagnosis and treatment. Full guideline 175. 2014.
    • Walsh AL, Considine S, Thomas AZ, et al. Digital rectal examination in primary care is important for early detection of prostate cancer: a retrospective cohort analysis study. Br J Gen Pract 2014; doi: 10.3399/bjgp14X682861