With the development of society and the change of diet structure, the number of prostate cancer patients in China is increasing, and the incidence of prostate cancer increased by 13.4% per year between 1994 and 2002 alone. The current physical examination usually checks the prostate-specific antigen (PSA), and its elevation may indicate prostate cancer. So, once PSA is elevated, what happens next? The current situation: 60% to 70% of patients are already in advanced stage when they visit the doctor. Since prostate cancer is relatively small in the early stage and does not constitute pressure on the urethra, it does not necessarily have any symptoms such as abnormal urination, so it is often difficult to detect it at an early stage without regular related examination. The treatment effect of prostate cancer differs greatly from one period to another: if it is early stage prostate cancer, the 10-year survival rate after surgery is basically above 90%, while the survival rate of advanced or highly malignant prostate cancer is only 70% to 80% in 5 years, not to mention the 10-year survival rate is greatly reduced. Therefore, it is important to have regular medical checkups, especially PSA screening, “especially for men over 50 years old, strive to have an annual checkup”, PSA: over 10ng/ml should be highly alert. The best way to detect early suspected prostate cancer is currently recognized. The PSA is called prostate-specific antigen, not prostate cancer-specific antigen, which means that “even if it is elevated, it is not necessarily prostate cancer.” Professor Zheng Shaobin, director of the Department of Urology at Southern Hospital of Southern Medical University, points out that any lesion of the prostate, such as prostatitis, prostate hyperplasia, or prostate cancer, may cause an elevation in PSA, and an anal finger test or after an intra-urethral examination may also cause an elevation in PSA. Generally speaking, “if PSA is elevated above 10ng/ml, especially if you are over 50 years old, you should be highly alert for prostate cancer”, Zheng Shaobin reminded. For PSA elevation between 4ng/ml to 10ng/ml, you can look at the ratio of fPSA (free PSA) to tPSA (total PSA), and if fPSA/tPSA is <0.1, it suggests a higher possibility of prostate cancer. Diagnosis: Puncture biopsy is the most reliable The most reliable method to confirm the diagnosis of prostate cancer is prostate puncture biopsy. For elevated PSA, small nodules in the prostate gland found by imaging or anal finger examination, puncture biopsy should be performed. Many patients have doubts or fears about puncture and hope that some non-invasive tests can diagnose prostate cancer. In this regard, M. Wu said, "At present, it is difficult to diagnose prostate cancer by imaging tests (such as CT, MRI, B-ultrasound) alone". However, patients often still need to have MRI examination while having prostate puncture or after the diagnosis is confirmed, because MRI examination can show the integrity of the prostate envelope, whether it invades the surrounding tissues and organs of the prostate, as well as the invasion of pelvic lymph nodes and bone metastases, in order to stage and choose different treatment methods.