The Role Of Psa In Choosing The Best Treatment
If you have received a diagnosis of prostate cancer, your PSA levels can be used along with the results of other tests and physical exams and your tumors Gleason score to help determine which tests are needed for further evaluation and to decide on the best treatment plan. After treatment has begun, your PSA and other tests will be used to determine how well the treatment is working: The more successful the therapy, the lower the PSA.
Preparing For A Prostate Exam
Theres nothing special that you need to do to prepare for a prostate exam. Tell your doctor if you have or hemorrhoids, as a DRE may aggravate these.
If you undergo a prostate cancer screening, your doctor will likely order a blood test, so inform the person drawing your blood if youre prone to dizziness.
Your doctor may ask you to sign a consent form before performing a cancer screening.
You can get a prostate exam easily and quickly at your doctors office. Generally, for prostate cancer screenings, your doctor will take a simple blood test.
How Often Is A Prostate Exam Necessary
Your frequency of testing may be due to several factors, including your age, family history, and present health condition:
4049 Years of Age: Most urologists recommend men aged 40 and above to undergo a prostate exam if they have a family history or personal history of prostate cancer. Also, African-American men should talk to their doctor about how often to have these tests performed because they are at a heightened risk. The PSA test is the gold standard for prostate screening, and your doctor may also perform a digital rectal exam .
Your test results will further determine how often you may need a prostate exam. Generally, if your PSA result is under 2.5, you will likely only need the test every two years. On the other hand, if the result is higher, your doctor will probably recommend an annual prostate exam.
If the number is beginning to increase, your physician will probably ask you to return within a matter of months to have a follow-up test because an increasing PSA could indicate the presence of cancer cells. You may also need a biopsy.
50 Years and Above: Men with an average prostate cancer risk start getting a PSA exam at age 50. At this age, your provider may recommend an annual PSA and DRE. Your doctor will guide you regarding future PSA tests because the frequency may change as you age.
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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.
What Happens If Psa Is High
A PSA level thats elevated may indicate prostate cancer, but it may also indicate other conditions, such as benign prostate hyperplasia or prostate infections. PSA levels can increase due to several factors, including age, infection, size of the prostate gland, and more.
If your PSA is high, your doctor may recommend another PSA test to confirm the number, and follow up with regular PSA tests and DRE exams to observe over time. If PSA continues to increase, your doctor might recommend additional testing and imaging.
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Should I Poop Before A Prostate Exam
You dont need to change any bathroom habits prior to your appointment. If you feel like you need to poop before your exam, then its fine to do so. But dont worry if you just dont have the urge. The prostate exam shouldnt make you feel like you need to go.
Theres no need to be embarrassed about fecal matter during your prostate exam. Your healthcare provider is experienced in performing this exam and will do everything to ensure your comfort during the process.
Getting The Results Of The Biopsy
Your biopsy samples will be sent to a lab, where they will be looked at with a microscope to see if they contain cancer cells. Getting the results usually takes at least 1 to 3 days, but it can sometimes take longer. The results might be reported as:
- Positive for cancer: Cancer cells were seen in the biopsy samples.
- Negative for cancer: No cancer cells were seen in the biopsy samples.
- Suspicious: Something abnormal was seen, but it might not be cancer.
If the biopsy is negative
If the prostate biopsy results are negative , and the chance that you have prostate cancer isnt very high based on your PSA level and other tests, you might not need any more tests, other than repeat PSA tests sometime later.
But even if many samples are taken, biopsies can still sometimes miss a cancer if none of the biopsy needles pass through it. This is known as a false-negative result. If your doctor still strongly suspects you have prostate cancer , your doctor might suggest:
- Getting other lab tests to help get a better idea of whether or not you might have prostate cancer. Examples of such tests include the Prostate Health Index , 4Kscore test, PCA3 tests , and ConfirmMDx. These tests are discussed in Whats New in Prostate Cancer Research?
- Getting a repeat prostate biopsy. This might include getting additional samples of parts of the prostate not biopsied the first time, or using imaging tests such as MRI to look more closely for abnormal areas to target.
Prostate cancer grade
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What If My Test Results Are Abnormal
If the results of early detection tests like the PSA test or the digital rectal exam suggest that you might have prostate cancer, your doctor will conduct further testing. The PSA may be repeated, or you may be sent to a specialist for more tests such as a transrectal ultrasound and a prostate biopsy.
In a prostate biopsy, a tissue sample is taken from your prostate. Cancer can only be diagnosed with a tissue sample.
In addition to a PSA test, DRE , and a biopsy, research has yielded additional tests that can detect if cancer is present, and if so, how aggressive that cancer might be:
- The Prostate Health Index combines three blood tests that give a more accurate Phi Score, which gives accurate information based on a high PSA to better determine the probability of finding cancer during a biopsy.
Research Needs And Gaps
There are many areas in need of research to improve screening for and treatment of prostate cancer, including
- Comparing different screening strategies, including different screening intervals, to fully understand the effects on benefits and harms
- Developing, validating, and providing longer-term follow-up of screening and diagnostic techniques, including risk stratification tools, use of baseline PSA level as a risk factor, and use of nonâPSA-based adjunctive tests that can distinguish nonprogressive and slowly progressive cancer from cancer that is likely to become symptomatic and affect quality or length of life, to reduce overdiagnosis and overtreatment
- Screening for and treatment of prostate cancer in African American men, including understanding the potential benefits and harms of different starting ages and screening intervals and the use of active surveillance given the large disparities in prostate cancer mortality in African American men, this should be a national priority
- How to better inform men with a family history of prostate cancer about the benefits and harms of PSA-based screening for prostate cancer, including the potential differences in outcomes between men with relatives who died of prostate cancer and men with relatives diagnosed with prostate cancer who died of other causes
- How to refine active prostate cancer treatments to minimize harms
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Should I Get Screened For Prostate Cancer
This video helps men understand their prostate cancer screening options.
In 2018, the U.S. Preventive Services Task Force made the following recommendations about prostate cancer screening
- Men who are 55 to 69 years old should make individual decisions about being screened for prostate cancer with a prostate specific antigen test.
- Before making a decision, men should talk to their doctor about the benefits and harms of screening for prostate cancer, including the benefits and harms of other tests and treatment.
- Men who are 70 years old and older should not be screened for prostate cancer routinely.
This recommendation applies to men who
- Are at average risk for prostate cancer.
- Are at increased risk for prostate cancer.
How Common Is Prostate Cancer
In the United States, the risk of a person with a prostate being diagnosed with prostate cancer is 11%. A person’s risk of dying from prostate cancer is 2.5%, and the average age that a person is when they die from it is 80.
Your risk for prostate cancer increases if you:
- Are over the age of 50 years old
- Are African American
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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.
Early Cancer Detection Can Save Lives And Cut Treatment Costs But When Should You Start Having Prostate Exams And Do You Need To Have Them At All
When it comes to screening for prostate cancer, some men may be confused or apprehensive about beginning to get annual exams.
As prostate cancer affects one out of every six men, the American Cancer Society and other leading medical organizations recommend older men discuss having annual prostate cancer screenings with their primary care doctor to help detect the disease early. Early detection of the disease helps cure it in 90 percent of cases.
Generally, it is recommended that men with an average risk of prostate cancer start being screened with a digital rectal exam and PSA blood-level exam when they hit the age of 50. African-American men and men who have a father, brother or son who were diagnosed with prostate cancer when they were younger than 65 are at higher risk and should start screenings at age 40. Men who have had more than one of these close relatives diagnosed before age 65 are at even higher risk.
The size of the prostate changes with age: Its the size of a walnut in younger men, while its larger in older men. Other than skin cancer, prostate cancer is the most common cancer in American men. According to the American Cancer Society, this year about 161,360 new cases of prostate cancer will be diagnosed, and 26,730 men will die from the disease.
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What Is The Recommended Age For A Prostate Exam
Did you know that prostate cancer is the second most common cancer in men, right after skin cancer? This terrible condition develops slowly and it is difficult to recognize in its early stages since it has very few symptoms. Nonetheless, as with any cancer, screening tests are the best way to diagnose any anomalies that could indicate there is a bigger problem. However, a prostate exam is not for everyone.
Should You Know Your Psa Level
Instead of a national screening programme, there is an informed choice programme, called prostate cancer risk management, for healthy men aged 50 or over who ask their GP about PSA testing. It aims to give men good information on the pros and cons of a PSA test.
If youâre aged 50 or over and decide to have your PSA levels tested after talking to a GP, they can arrange for it to be carried out free on the NHS.
If results show you have a raised level of PSA, the GP may suggest further tests.
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Can I Check My Own Prostate
It is not recommended that you try to check your own prostate.
The prostate is an internal gland, and performing a self-examination could cause harm. For your safety, the exam should be performed by a licensed healthcare professional.
Additionally, a professional will be better able to assess if there is a reason for concern.
Early Detection Saves Lives
Its a fact: The sooner it is caught, the easier prostate cancer is to treat. Dont wait to speak with a doctor about screening for prostate cancer, especially if you are experiencing these common signs of prostate problems :
- Frequent urination at night
- Recurring bladder infections
- Burning sensation when urinating
Crystal Run Healthcares urologists are dedicated to mens health. No matter your age or stage of life, we will empower you with the information you need to make important and informed choices about your health.
We offer consultation with prostate screening and cancer specialists, as well as primary healthcare practitioners so that you can understand your screening and treatment options. Discover how Crystal Run Healthcare can make a difference to your health and your life call 845-703-6999 to book your consultation.
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Schedule Your Prostate Exam Today
At Northern Inyo Healthcare District, our urology services focus on the urinary tract and system, including the kidneys and bladder, as well as reproductive organs. Our expert team treats a full range of conditions and performs surgery at our hospital if necessary with our state-of-the-art da Vinci Xi Surgical System.
To stay on top of your prostate health, schedule a prostate exam with our Rural Health Clinic today by calling 760-873-2849.
Patient Population Under Consideration
This recommendation applies to adult men in the general US population without symptoms or a previous diagnosis of prostate cancer. It also applies to men at increased risk of death from prostate cancer because of race/ethnicity or family history of prostate cancer. The sections below provide more information on how this recommendation applies to African American men and men with a family history of prostate cancer.
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The Ideal Prostate Exam Age: Is It About That Time
A routine prostate exam is essential in evaluating the risks and symptoms of prostate cancer, benign prostatic hypertrophy , prostatitis , and other prostate-related conditions. As one in nine men will be diagnosed with prostate cancer in their lifetime, prostate tests and exams are highly recommended for all men of a certain age .1 Once you reach your recommended prostate exam age, youll want to consult with your physician about setting up your first regular exam. In the meantime, weve put together a general overview of exactly what you need to know about your first prostate exam.
What To Expect During The Study
This type of test can be done easily and quickly in your doctors office. In the first instance, a rectal examination is carried out to rule out anything abnormal, such as lumps and hard or soft areas. The urologist can also feel if the prostate is in a larger than the normal state.
If your doctor feels any abnormalities when performing the rectal exam, he or she will probably recommend a blood test. The blood test will indicate at what level the prostate cancer is, but it can also indicate other conditions, such as BPH or prostate infections. If you show abnormalities in your rectal exam and high levels in the blood test, the specialist may recommend additional tests such as:
- Transrectal ultrasound
- Prostate biopsy
- Magnetic Resonance Scan
Keep in mind that if any of the screening tests have unfavorable results, you should talk to your doctor about the next plan to perform. This will depend on your age, health status, and family history.
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Should I Have A Prostate Cancer Screening Test
Routine testing for prostate cancer in all men without symptoms is not recommended in New Zealand at present. Being tested for prostate cancer is your choice. Learning about the pros and cons of prostate testing can help you decide if it is right for you.
To help you decide if a prostate check is right for you, the Ministry of Health has developed the Kupe website. It will help you understand the risks, benefits and implications of prostate testing, so you can have an informed conversation with your doctor.
If you are unsure about whether you need to get tested for prostate cancer, contact your GP for a discussion on the risks and benefits of testing.