What Does A Prostate Exam Include
Many people feel nervous or embarrassed about getting their prostate checked, but it is a painless and fairly quick process.
The examination may include the doctor checking your prostate gland.
To do this your doctor puts a gloved finger into your rectum to check for abnormal signs, such as a lumpy, hard prostate. This test is called a digital rectal examination .
You might also be asked to provide a urine sample and undergo a blood test, while further testing can also include an MRI scan or biopsy.
Whats The Recommended Age For Your First Prostate Exam
Starting at age 50, all men should discuss getting a prostate exam with their doctor.
The reason for this is prostate cancer. In the UK, about one in eight men will be diagnosed with this in their lifetime. It mainly affects men aged 50 plus, but your risk increases as you get older, and the most common age to be diagnosed is between 65 and 69 years. Most men with early prostate cancer dont have any noticeable signs or symptoms.
The exception to this rule is if you are experiencing symptoms, or if your genetics predispose you as higher risk. Doctors are increasingly finding the tendency towards some prostate cancers can be inherited from your fathers family. Additionally, black men are at a higher risk, with one in four getting prostate cancer in their lifetime.
If youre experiencing no symptoms, heres the recommended age for prostate exam:
- If you have a family history, first prostate exam at age 40
- If you are black, first prostate exam at age 45
- If you have no family history and youre not black, first prostate exam at age 50
What Do You Want Men To Know About Prostate Cancer
The important thing to know is that, if you live long enough, you will probably get prostate cancer. If you live into your 80s, about 80 percent of men have some sort of prostate cancer. That doesnt mean theyre going to die from prostate cancer because, as a percentage, very few men die from prostate cancer. It means its important to be aware of it and consider screening early, so if its a high-grade type, we can identify it and treat it.
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Two Main Screening Tests
There are two tests commonly used to screen for prostate cancer:
- The Digital Rectal Exam : A doctor or nurse inserts a gloved, lubricated finger into the rectum to estimate the size of the prostate and feel for lumps or other abnormalities.
- The Prostate Specific Antigen Test: This exam measures the level of PSA in the blood. The levels of PSA in the blood are often higher in men who have prostate cancer. The PSA level may also be high in other conditions that affect the prostate.Usually, the higher the bloods PSA level is, the more likely it is that a prostate problem is present. But other factors, such as age and race, also can raise PSA levels. PSA levels also can be impacted by certain medical procedures, some medications, an enlarged prostate or a prostate infection.Since your PSA level may be high for other reasons, your doctor will need to interpret the test results.
If the results of the PSA and/or DRE suggest that you might have prostate cancer, your doctor will need to do a prostate biopsy to find out. This means a sample of your prostate tissue will be removed with a needle and sent to a lab, where a specialist will determine if it contains cancer cells.
Prostate Exam Vs Colonoscopy: Whats The Difference
At first glance, it might seem that a prostate exam is similar to a colonoscopy. After all, both exams involve your rectal area. However, these two tests are quite different.
While a prostate exam involves feeling the prostate with a gloved finger, a colonoscopy examines the walls of your colon by inserting a flexible camera into your rectum. The prostate is not examined at all during this procedure unless your healthcare provider manually performs an exam.
A prostate exam is a fairly quick procedure performed in an office setting. A colonoscopy, on the other hand, is an outpatient procedure in the hospital that requires IV sedation.
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What To Do If You Think You Are At Higher Risk Of Prostate Cancer
Speak to your GP if you think you are at higher risk of prostate cancer. For example if you:
- are a Black male or a Black person who has a prostate
- have a close relative, such as brother or father, who has prostate cancer
- have inherited certain genes which can increase the risk of prostate cancer
The risk of prostate cancer also increases as men get older.
The evidence so far suggests that routinely screening people who have a high risk of prostate cancer doesnt help prevent deaths. In fact, it might lead to men having treatment for prostate cancer even though that cancer wouldnt have caused any problems or symptoms.
The Importance Of Prostate Health
Aside from skin cancer, prostate cancer is the most common cancer in men. According to the American Cancer Society, one in eight men will be diagnosed with prostate cancer, and one in 41 men will die from prostate cancer. More than 90 percent of men aged 80 or older have an enlarged prostate.
The prostate is a small, walnut-shaped gland that is a vital part of the male reproductive system. Located below the bladder and in front of the rectum, the prostate produces seminal fluid, which helps nourish and transport sperm.
There are several risk factors for prostate cancer, including age, family history and race. African American men are at a higher risk for prostate cancer than Caucasian men. Men with a father or brother diagnosed with prostate cancer also are at an increased risk.
Why Prostate Screening Is Important To Discuss After Age 55
Prostate cancer is both treatable and curable. Yet, this year, it will claim the lives of almost 30,000 men, according to the American Cancer Society.1 Screening via prostate exams and a blood test can ensure early detection and treatment. Heres why prostate cancer screening is important to discuss for all men over 55 years old.
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Surgical procedures to remove the diseased prostate are usually necessary. Surgical procedures are not always necessary. If the disease is caused by bacterial infections, a doctor can treat the symptoms using alpha-blockers or surgery. Physical therapy, relaxation exercises, and warm baths are all recommended. A physician may also prescribe antibiotics to cure the infection. A bacterial infection can also cause a recurrence of the condition.
An enlarged prostate can be uncomfortable for both men and women. Some of the symptoms of an enlarged male reproductive organ include a weakened urine stream, urgent need to urinate, and urinary tract infections. BPH can also cause damage to the kidneys. A sudden inability to urinate can be life-threatening, as it can lead to bladder and kidney damage. Unfortunately, most men with enlarged prostrates put up with the symptoms for years before they seek treatment. However, many of the men with symptoms finally decide to go to a doctor for proper gynecological evaluation and to begin enlarged prostatic therapy.
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Who Should Get A Psa Test
Not everyone should get a PSA test. Why? Because many in this country are treated for low-risk prostate cancer that is discovered through the PSA test, even when it is unlikely that the disease will ever cause symptoms or lead to death. And treatment is associated with significant side effects, including impotence and incontinence . You should discuss whether prostate cancer early detection is right for you with your personal primary care physician.
To avoid the risks of over-treatment, Roswell Park follows the guidelines established by the National Comprehensive Cancer Network . The NCCN brings together world-renowned experts from 30 of the nations top cancer centers to write guidelines that specify the best ways of preventing, detecting and treating cancer. The guidelines are updated at least every year, on the basis of the latest research.
Michael Kuettel, MD, PhD, MBA, Chair of Roswell Park’s Department of Radiation Medicine, serves on the NCCN Prostate Cancer Panel.
If you decide that Prostate Cancer Early Detection is right for you, the NCCN recommends PSA testing as follows:
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Symptomatic treatment of an enlarged prostate usually involves a combination of medication and lifestyle changes. A diet rich in fruits and vegetables may be the best option if you suffer from chronic urination. It will help the body adjust to the increased size of the prostate. Also, taking regular urination intervals will help retrain the bladder to function properly. Inactivity also contributes to urine retention, and cold temperatures can increase the urge to urinate.
Invasive treatment of enlarged prostate includes medication that relieves the pressure on the urethra and bladder. However, if the condition is severe, it may require surgical intervention. If treatment is not successful, the enlarged prostate can become a potentially life-threatening disease. As the hormone levels in the body change, the enlarged prostate can lead to various complications, including urinary retention and even cancer. This is why it is critical to see a doctor for further evaluation.
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When To Start Prostate Exams
The American Cancer Society recommends that men aged 50 start prostate cancer screenings. However, African American men and men with a family history of prostate cancer should start screening at age 45. In general, most experts recommend getting a prostate exam every three to five years.
Your doctor will check the prostate gland for any lumps or abnormalities during a prostate exam. It’s not painful, but some men may feel uncomfortable during the exam.
These are some types of prostate exams:
- Digital Rectal Exams : During a DRE, the doctor physically examines the rectum to feel for any abnormalities in the prostate. This exam can help detect prostate cancer in its early stages
- Prostate-Specific Antigen Tests : A PSA test measures the level of PSA, a protein produced by the prostate present in the blood. A high PSA level may be a sign of prostate cancer
If any of the above tests is abnormal, further testing may include:
- Biopsies: A needle is used to sample tissues for cancer cells. This is typically done as an MRI-guided biopsy.
- Screening Tests: Screening tests can sometimes have incorrect or unclear test results, making it essential to speak with your doctor about the risks and benefits of this test. Men should talk to their doctor about how often they should get a prostate exam, depending on their health status.
Does Screening Reduce Pc Mortality
The European Randomized Study of Screening for Prostate Cancer is the worlds largest randomized controlled trial on PSA-screening including 162,388 men aged 5569 years in 8 European countries . The 13-year follow-up report showed that PSA-screening every 24 years reduces PC mortality by 21%. The reduction in PCa mortality was even larger44% at 14 yearsin the Göteborg trial where 20,000 men ages 5064 were randomized to biennial PSA-screening or a control group . The U.S. Prostate Lung Colorectal and Ovarian cancer screening trial randomized 76,685 men aged 5574 years but did not show any difference in PCa mortality between the screening and control arm . The reason for this was high pre-screening rates in both arms and a high contamination rate in the control arm i.e., the two arms were subjected to almost the same amount of screening . However, with these discrepancies accounted for, both the ERSPC and PLCO trials provide compatible evidence that PSA screening reduces PC mortality . There is also compelling evidence from observational data. In the U.S., where the PSA test was introduced as a screening tool in the early 90s, the age-adjusted death rate from PCa dropped 51% between 1993 to 2014 .
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Weighing Your Options For Treatment
If you test positive for prostate cancer, you have some options as to what youd like to do about it. Until recently, nearly everyone opted for surgery or radiation, while some patients choose not to undergo treatment, instead opting for active surveillance, during which the cancers are left alone but regularly monitored to be certain that theyre not growing.
Certainly, screening can lead to earlier prostate cancer detection, and with earlier detection, youre eligible for multiple different treatments or active surveillance, said Sia Daneshmand, MD, director of urologic oncology at USC Urology of Keck Medicine of USC and associate professor of urology at Keck School of Medicine of USC. So we encourage patients who are candidates for screening to discuss it with their urologist and/or primary care physician so that we can determine whats the best course of treatment for them.
There also is a new option for those seeking prostate cancer treatment. Its called High-Intensity Focused Ultrasound , which uses ultrasound beams to non-surgically destroy prostate tumors.
Who Should Get A Digital Rectal Exam
Not all medical institutions agree on when men should begin screening for prostate cancer or even if a DRE should be part of the screening.
To help detect prostate cancer in its early stages, the American Cancer Society recommends that men talk to their doctors about the benefits, risks, and limitations of prostate cancer screening before deciding whether to be tested.
For most men at average risk, discussions about screening begin at age 50. However, some doctors recommend that men at higher risk of prostate cancer — African-American men or men with a family history of prostate cancer — start screening earlier.
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What Happens During A Prostate Exam
You dont need to do anything specific to prepare for a DRE. Your provider will walk you through the steps of a DRE, but ask them questions if any parts of the exam are not clear.
A DRE can be done while you are standing or lying down. Your position will depend on factors like the layout of the exam room and any health conditions you may have.
If youre going to stand during a DRE:
Who Needs Screenings
Measuring the PSA level can increase the chance of finding prostate cancer when it is very early. But there is debate over the value of the PSA test for detecting prostate cancer. No single answer fits all men.
If you’re 55 through 69 years old, before having the test, talk to your provider about the pros and cons of having a PSA test. Ask about:
- Whether screening decreases your chance of dying from prostate cancer.
- Whether there is any harm from prostate cancer screening, such as side effects from testing or overtreatment of cancer when discovered.
- Whether you have a higher risk of prostate cancer than others.
If you are age 55 or younger, screening is not generally recommended. You should talk with your provider if you have a higher risk for prostate cancer. Risk factors include:
- Having a family history of prostate cancer
- Being African American
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How Do I Get Tested
A general practitioner or an urologist can perform a full prostate cancer exam. This should include a PSA blood test and a digital rectal exam .
A Prostate-Specific Antigen blood test measures the level of PSA in the blood. PSA is a substance made by the prostate. The levels of PSA in the blood can be higher in men who have prostate cancer. The PSA level may also be elevated in other conditions.
A Digital Rectal Exam is a physical exam that is done when a doctor or nurse inserts a gloved, lubricated finger into the rectum to estimate the size of the prostate and feel for lumps or other abnormalities.
Talk to your general doctor or urologist about receiving a prostate exam. If you do not have a doctor, do not have insurance, or cannot afford a test, find out what free screenings are available in your area on our Free Testing Map. If you do not see a free screening in your area, check back in the fall. Many screenings occur in September, during Prostate Cancer Awareness Month.
Recent research has yielded additional tests that in addition to the PSA test and DRE and biopsy that can give a doctor more information on to determine the probability of both finding cancer during a biopsy and determining how aggressive that cancer is likely to be. Learn more here.