Roger Babaian, M.D.: PSA stands for Prostate Specific Antigen. It is a test that men have by having their blood sampled and what we look for is a particular glyco-protein that's found in the blood. Above a certain level the value is considered abnormal and raises the index of suspicion that cancer may be present.

Narrator: While the use of the test remains controversial, a normal PSA level is considered to be less than 4.0. Any number greater than that suggests that further testing may be required.

Physician: OK, what I'd like to do is just do a rectal examination and feel that prostate.

Narrator: The other necessary test for detection is the digital rectal exam.

Barry Trevithick: It doesn't make sense to be afraid of something like that and it is nothing to be afraid ofand it isn't dehumanizing unless you choose to make it that way.

Christopher Wood, M.D.: A patient who comes to us needs to know that just because they do have an abnormality in their rectal examination does not mean that they have prostate cancer. It means that we're concerned about it and they should go on to have other tests, such as a trans-rectal ultrasound and a biopsy.

Physician: Now, just relax--the best thing to do if you have any discomfort is take slow, deep breaths through your open mouth.

Narrator: When a digital rectal exam or PSA test indicates an abnormality, an ultrasound image is made of the prostate gland. Usually these are accompanied by a biopsy--a sampling of the prostate tissue with a needle.

Physician: Now there's a little pressure-- you can probably feel that. Then you're going to hear a click noise--don't jump. [ click ] Just relax, the worst is over.

John Bertini, M.D.: The patient feels in general a pressure sensation but not pain that an anesthetic would be necessary.