Monday, September 26, 2022

At What Age Is The Prostate Exam

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Research Into Prostate Cancer Screening

What it’s like to go for a rectal screening for prostate cancer

Research is ongoing to find other prostate cancer screening tests and ways to improve the current test. This includes:

  • new blood and urine tests
  • a combination of a blood test and other information such as age and family history
  • MRI and other types of scans

More research is needed to find out whether these tests are reliable enough to detect prostate cancer.

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.

Why Is A Prostate

A PSA blood test is performed to detect or rule out prostate cancer. The amount of PSA in the blood is often higher in men who have prostate cancer. However, an elevated PSA level does not necessarily indicate prostate cancer. The U.S. Food and Drug Administration has approved the PSA blood test for use in conjunction with a DRE to help detect prostate cancer in men age 50 or older and for monitoring men with prostate cancer after treatment. However, much remains unknown about how to interpret a PSA blood test, its ability to discriminate between cancer and problems such as BPH and prostatitis, and the best course of action if the PSA level is high.

When done in addition to a DRE, a PSA blood test enhances detection of prostate cancer. However, the test is known to have relatively high false-positive rates. A PSA blood test also may identify a greater number of medically insignificant lumps or growths, called tumors, in the prostate. Health care providers and patients should weigh the benefits of PSA blood testing against the risks of follow-up diagnostic tests. The procedures used to diagnose prostate cancer may cause significant side effects, including bleeding and infection.

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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.

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Prostate exam: How is it done and who should have one?

Dr. Matthew Rettig, the medical director of the Prostate Cancer Program at the Institute of Urologic Oncology at UCLA in California, said that even if screenings aren’t performed right away, men should at least start talking about them with their doctors early in life.

“I think I would have that conversation fairly early on in life, maybe even in 30s or 40s, about when to initiate screening,” said Retting. “I think that would be most important for patients who are at high risk for prostate cancer and high risk for early onset of prostate cancer. Those are the types of patients that probably ought to have the discussion and make a decision about when to start screening at a relatively young age.”

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Deciding If You Need A Prostate Screening

  • 1Determine the necessity of a screening based on your age. The American Cancer Society suggests a yearly prostate screening for all men age 50 and over. However, select circumstances may warrant screenings beginning at an earlier age. These include:XTrustworthy SourceAmerican Cancer SocietyNonprofit devoted to promoting cancer research, education, and supportGo to source
  • Age 40 for men with more than one first-degree relative who had prostate cancer before age 65.
  • Age 45 for men with a single first-degree relative who had prostate cancer before age 65.
  • Age 45 for African American men due to carrying a higher risk of prostate cancer.
  • 2Note any symptoms associated with your urinary system. Problems associated with your bladder, urethra, and penis can all potentially have ties to prostate problems.XExpert SourceRobert Dhir, MDBoard Certified Urologist & Urological SurgeonExpert Interview. 23 September 2020. Due to the proximity of the prostate to these systems it can grow and press against them causing dysfunction. With prostate issues you may experience the following:XResearch sourceBickley, Lynn S. Techniques of Examination. Chapter 15 The anus, rectum and prostate. Bates Pocket Guide to Physical Examination and History Taking. sixth edition. P 262-264. © 2009 Wolters Kluwer Health- Lippincott Williams & amp Wilkins.
  • Slow or weak urine streams
  • Difficulty urinating
  • Lower back pain
  • A biopsy may also be necessary to confirm or rule out cancer.
  • Do All Men Who Are Treated For Prostate Cancer Lose Sexual And Urinary Function

    Its definitely not true that all men are incontinent and impotent after treatment for prostate cancer. Urinary incontinence is usually temporary.

    There can be a sexual impact for guys who have normal function. If the cancer is near their nerve bundle, theyre going to have a decrease in sexual function. If its not, and we can do bilateral nerve sparing surgery, studies show 70 percent can get back their normal sexual function. It all depends on where the cancer is. But the truth is that we cant predict very well who will be the 30 percent who will haveor still haveED some already do have ED because of age, diabetes, hypertension or renal failure.

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    What Is A Digital Rectal Exam

    The most common way for doctors to check on the health of your prostate is with a DRE. Its a fairly quick and simple procedure.

    For the exam, youll bend at the waist while standing or lie on your side with your knees bent toward your chest.

    Your doctor will lubricate a gloved finger and gently place it inside your rectum. Theyll press one hand on your prostate, and their other hand will feel your pelvic area. It should only take a few moments.

    You may experience momentary discomfort. You may also feel the urge to urinate, especially if your prostate is enlarged or inflamed.

    Your doctor will be able to tell you if your prostate seems to be a normal size and shape. In general, a DRE has no risks.

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    Symptoms Of Prostate Cancer

    Prostate Cancer Treatment

    Symptoms of prostate cancer do not usually appear until the prostate is large enough to affect the tube that carries urine from the bladder out of the penis .

    When this happens, you may notice things like:

    • an increased need to pee
    • straining while you pee
    • a feeling that your bladder has not fully emptied

    These symptoms should not be ignored, but they do not mean you have prostate cancer.

    Its more likely theyre caused by something else, such as prostate enlargement.

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    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.

    Do You Really Need An Annual Prostate Exam

    Common knowledge used to hold that men over the age of 50 needed to get an annual digital prostate exam. Catching cancer early is important, but do men really need to get the uncomfortable procedure every year? Dr. Tom Miller has some good news for men about modern prostate screenings.

    Interviewer: Your annual prostate exam. Is it still something that you should have done every year, or can you skip it? We’ll find out next on The Scope.

    Announcer: Help information from experts supported by research from the University of Utah Health. This is the scoperadio.com.

    Interviewer: Dr. Tom Miller, so, at one point, I know that every year that they said you should get a prostate exam if you’re after over 50 years old. Do you have to still do that anymore, or is there a better way?

    Interviewer: All right. So, just to clarify, because I mean this is a bit of a paradigm change for me. It feels a little weird like . . .

    Dr. Miller: Well, most men would tell you that.

    Interviewer: Yes, I don’t mean in that way, but it feels a little strange that we’re saying now you don’t need to do the rubber glove and the whole thing, that there’s actually an alternative test you’re talking about. Tell me more about that test.

    Interviewer: Got you. So it’s just a blood draw that would start after the age of 50, earlier, if you have a family history?

    Dr. Miller: Average comers starting at the age of 50.

    Interviewer: Got you, and there’s some symptoms or something going.

    Dr. Miller: Correct.

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    How Should I Prepare For The Exam

    You should tell your doctor if you have hemorrhoids, anal tears, or other problems with your anus. The exam will be easier if you breathe normally and try to relax.

    Before having a PSA test, tell your doctor about any medications and supplements you take. Recent ejaculation can also affect your PSA levels. Ask your doctor if you should abstain from sexual activity before the test.

    Your blood must be sent to a laboratory for analysis, so your PSA results wont be available immediately. Your doctor will let you know when they have the results.

    The lab report will show the level of PSA in your blood as:

    In addition to looking at the amount of PSA in your blood, your doctor will assess how quickly this number is changing. Many things can affect PSA, so test results require careful analysis by an expert. Your doctor will take all of your health information into account.

    If you have an abnormal PSA test result, it doesnt mean you have prostate cancer. Most men with a high PSA level dont have prostate cancer. About of men who have a biopsy due to a high PSA level have prostate cancer.

    Its also possible for men with prostate cancer to have normal DRE and PSA test results.

    Finding Prostate Cancer Early

    Digital Rectal Exam: Uses, Side Effects, Procedure, Results

    There is no national screening program for the early detection of prostate cancer. Doctors have different opinions about whether all men without symptoms of prostate cancer should be tested.

    There is concern that testing healthy men will cause unnecessary harm and lead to treatments that may not offer long-term benefits. Treatment for prostate cancer can leave men with side effects such as erectile dysfunction and continence issues, which can affect their quality of life.

    Testing may identify fast-growing or aggressive cancers that have the potential to spread to other parts of the body and would benefit from treatment. It may also detect very slow-growing cancers that are unlikely to be harmful.

    Weigh up all the risks and benefits before deciding whether to be tested for prostate cancer, particularly if you dont have symptoms. Talking to your doctor can help.

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    How Is Prostate Cancer Detected

    There is no single test to detect prostate cancer. The two most common tests are the prostate specific antigen blood test and the digital rectal examination .

    The PSA test measures the level of PSA in your blood. It does not specifically test for cancer. Virtually all PSA is produced by the prostate gland. The normal range depends on your age. A PSA above the typical range may indicate the possibility of prostate cancer. However, two-thirds of cases of elevated PSA are due to noncancerous conditions such as prostatitis and BPH.

    A DRE is generally conducted by a urologist to feel the prostate. While DRE is no longer recommended as a routine test for men who do not have symptoms of prostate cancer, it may be used to check for any changes in the prostate before doing a biopsy.

    If either of these tests suggest an abnormality, other tests are necessary to confirm a diagnosis of prostate cancer, usually a magnetic resonance imaging scan and transrectal ultrasound biopsy.

    What Happens During A Dre Examination

    The DRE requires the insertion of a gloved and lubricated finger into the rectum by a doctor to check the size of the prostate and confirm the presence or absence of any abnormalities. This test is important because it can uncover signs of prostate problems that may require further testing, which is why its usually the first test performed.

    Men who have conditions like hemorrhoids are strongly advised to inform their doctor so that worsening of the condition by the test can be prevented.

    The PSA blood test is the current recommended test for screening. Typically taking place after the DRE, the PSA test detects levels of the protein-specific antigen, made by the prostate, in the blood.

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    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.

    When Should I Call My Healthcare Provider

    10 Warning Signs of Prostate Cancer

    If youre 50 and you havent had your first prostate exam yet, call your healthcare provider to set up an appointment. If youre at higher risk, such as if you’re Black or prostate cancer runs in your family, you should have your first prostate exam by age 45.

    Furthermore, if you develop symptoms of urinary tract obstruction, schedule a visit with your provider right away. This may indicate an enlarged prostate, benign prostatic hyperplasia or a urinary tract infection.

    A note from Cleveland Clinic

    Most people are understandably apprehensive about their first prostate exam. Learning all you can about the process can help abate any fears or uncertainties you have. Talk to your healthcare provider about your screening options. A prostate exam is the first step in the early detection of prostate cancer and early detection is key to successful treatment.

    Last reviewed by a Cleveland Clinic medical professional on 04/04/2022.

    References

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    What Happens During A Prostate Exam

    Prostate exams might be uncomfortable. Here is what to expect when you receive your first prostate exam. Prostate exams can include two major tests: the PSA blood test and a digital rectal exam .

    PSA Blood Test

    The PSA test measures the amount of prostate-specific antigen in your blood. PSA is a protein that is produced by your prostate. Normally, your prostate produces only small amounts of PSA. However, if you have prostate cancer or diseases such as benign prostate hyperplasia , your prostate might release more amount of PSA. As such, high levels of PSA can indicate disease.

    Digital Rectal Exam

    The DRE exam is used to physically examine the size, shape, and texture of your prostate. In order to examine your prostate, your doctor will insert a lubricated, gloved, finger into your rectum to inspect your prostate. This exam should not be painful and will only last 1-2 minutes. Your doctor will be feeling for hard, lumpy, or other abnormalities of the prostate. Although slightly uncomfortable, this test can be extremely helpful for detecting prostate cancer at an early age.

    During the exam, you will be asked to remove your clothing and put on a hospital gown. There are a number of possible positions to stay in but will completely depend on your physician and your own preference. For instance, you can lie on your side, bend over the table, or squat on the exam table. These options will be disclosed to you by your doctor.

    How to Prepare for a Prostate Exam

    What Would You Say To Men Who Dont Want To Get A Prostate Check

    A rectal exam is recommended but optional. We recommend both, but if theyll just let you do a blood test, thats better than not doing anything at all.

    If concern about the rectal exam is the only reason youre not getting screened, talk to your doctor about it. We can discuss the risks and benefits. None of the evaluation tests are mandatory, but the reason we do that is that it improves our ability to detect cancer. So, if thats why youre not being evaluated, we can talk and decide if we can do other tests.

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