The Cytodiagnosis of Prostatic Cancer

Careful digital examination of the prostate is one of the most rewarding cancer screening tests performed.¹⁹ The detection of an area of induration or nodularity in the prostate is sufficient evidence that a malignant lesion may be present to warrant a biopsy. However, early curable carcinoma of the prostate may be present in a gland which the examiner feels is normal, uniformly enlarged, or "slightly abnormal." The microscopic examination of prostatic secretions may expand the diagnostic armamentarium of the clinician. Abnormal cells which suggest the presence of malignancy may alert the physician to the need for further evaluation and biopsy confirmation.

Prostatic secretion for examination can be obtained in adequate amounts in most situations with minimum discomfort to the patient. Examination of prostatic fluid obtained by massage is preferred to the examination of urine. However, a voided urine specimen following massage may yield malignant cells when prostatic fluid is