Prostate exam. PSA, or prostate-specific antigen, is a protein produced in the prostate. A PSA test, which is a simple blood test, can measure the level of PSA in the blood. A PSA that rises or is elevated, such as above 4.0 ng/mL, may indicate prostate cancer. However, the PSA test is not specific for prostate cancer. An elevated PSA could also mean an enlarged prostate or prostatitis (a prostate infection). Most doctors don’t test the PSA, except for urologists.
A DRE, or digital rectal exam, can detect growths or enlargement of the prostate. Any abnormalities, such as firmness, nodules, or other irregularities, may indicate prostate cancer. Men should have an annual DRE starting at age 40 to check for any changes in the prostate from the previous prostate exam. Again, men who have a higher risk for prostate cancer, such as African-American men and men with a family history of prostate cancer, should get tested annually.
Hematuria. Blood in the urine is not normal. It may be an early warning sign of a number of serious health conditions, such as a bladder or kidney infection, kidney stones, kidney cancer, or bladder cancer. If you see blood in your urine, the urologist will start by doing a simple urine test called a urinalysis to test for the presence and amount of microscopic blood in the urine. They may also do a cystoscopy to look inside your bladder, or refer you for an x-ray or CT scan. Do not wait to see a urologist if you see blood in your urine. It usually means something is wrong and in that case, will not go away on its own.
Testicular pain or lump. Testicular pain occurs in or around one or both testicles. The pain felt in your testicles does not always mean the source is in your testicles; it could be pain caused by another area of the body such as in the abdomen or groin. Testicular pain may be caused by a number of different things including inflammation, hydrocele, kidney stones, inguinal hernia, scrotal mass, urinary tract infection, varicocele, or even testicular cancer.
Kidney pain or mass. If you are experiencing abdominal pain, your primary care doctor may refer you to have a CT scan or an ultrasound. While the scan may or may not show what is causing the pain, it can identify if there is a mass on the kidney. If a mass has been found in your kidney, do not let anyone do a biopsy the mass until you have seen a urologist. While it is assumed that the mass could be kidney cancer, it can also mean a cyst (fluid-filled sac), an infection, or hydronephrosis (partial blockage of kidney). It’s important to see a urologist before having your kidney biopsied in order to rule out other causes of the mass. A urologist may do a urine cytology, a cystoscopy, additional blood work, or order additional scans to check what could be causing the mass.