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.
Previous Studies Have Similarly Found Psa Tests To Be More Useful To Patients For Prostate Cancer Testing
WINSTON-SALEM, N.C., Sept. 6 — Among the least favorite of all medical exams, the digital rectal exam for prostate cancer may be on the way out because other tests are more accurate in detecting the disease.
A large review of medical data found digital rectal exams gave false positives and often turned men off to any type of test for prostate cancer, according to researchers at Wake Forest University.
Digital rectal exams have long been a standard method for prostate cancer testing, despite an enlarged prostate not necessarily indicating cancer and the requirement for more testing if the prostate is enlarged.
The United States Protective Services Task Force in 2011 dropped its recommendation for routine prostate-specific antigen testing for all men over age 50 — which has resulted in fewer diagnoses of prostate cancer, according to a study earlier this year — but has not addressed recommendations for digital rectal exams.
A study at Harvard University in June also showed PSA tests are the best method for detecting prostate cancer, despite the tests often showing false positives and requiring further confirmation of the threat of more deadly forms of the disease.
For the study, , researchers analyzed data on 38,340 men in the prostate, lung, colorectal and ovarian screening trial who received annual PSA and digital rectal examinations.
What To Expect During The Exam
You can get a prostate exam easily and quickly at your doctors office. Generally, for cancer screenings, your doctor will take a simple blood test.
Your doctor might also choose to perform a DRE. Before performing this exam, your doctor will ask you to change into a gown, removing your clothing from the waist down.
During a DRE, your doctor will ask you to bend over at the waist or lie on the exam table in a fetal position, with your knees to your chest. They will then insert a gloved, lubricated finger into your rectum.
Your doctor will feel for anything abnormal, such as bumps or hard or soft areas that might indicate a problem. Your doctor may also be able to feel if your prostate is enlarged.
A digital rectal exam can be uncomfortable, especially if you have hemorrhoids, but isnt overly painful. It will last only a couple of minutes.
A DRE is one of your doctors tools that can help them detect several prostate and rectal problems, including:
- BPH
- prostate cancer
- abnormal masses in your rectum and anus
Your doctor will be able to tell immediately if there are any areas of concern that may warrant further testing.
The results of a DRE exam are either normal or abnormal, but doctors typically rely on several different tests to help them make a prostate cancer diagnosis.
If your doctor feels something abnormal during the DRE, they will probably recommend getting a PSA blood test, if you havent done so already.
- transrectal ultrasound
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Is It Time You Booked A Prostate Exam
Prostate checks are a part of life for most adult men. Its a necessary step to ensure that you stay on top of your health and become aware of any abnormalities before they evolve into serious problems.
For many men, it can be a nervous time. General Practitioner, Dr Sir-Kit Leong, from SmartClinics Clayfield in Brisbane has answered some of the most frequently asked questions by patients. Take a read and if youre still unsure, book an appointment with your GP for a chat before committing.
What Does Prostate Cancer Screening Entail
There are two types of prostate cancer screening exams and both should be done in conjunction with the other: A digital rectal exam and a prostate-specific antigen blood test .
A DRE is a physical exam in which the physician lubricates a gloved finger to gently examine the patients rectum. If it is enlarged or irregular in shape, the doctor will be able to easily detect it. While it may be uncomfortable, the test brief and can be life-saving.
A PSA test is a blood test that measures the level of prostate-specific antigens in the blood. Rising levels of PSA can be one of the first signs of prostate cancer, allowing for early detection and treatment.
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Symptoms Of Prostate Cancer
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.
It’s more likely they’re caused by something else, such as prostate enlargement.
Deciding If You Need A Prostate Screening
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American Cancer Society Recommendations For Prostate Cancer Early Detection
The American Cancer Society recommends that men have a chance to make an informed decision with their health care provider about whether to be screened for prostate cancer. The decision should be made after getting information about the uncertainties, risks, and potential benefits of prostate cancer screening. Men should not be screened unless they have received this information. The discussion about screening should take place at:
- Age 50 for men who are at average risk of prostate cancer and are expected to live at least 10 more years.
- Age 45 for men at high risk of developing prostate cancer. This includes African Americans and men who have a first-degree relative diagnosed with prostate cancer at an early age .
- Age 40 for men at even higher risk .
After this discussion, men who want to be screened should get the prostate-specific antigen blood test. The digital rectal exam may also be done as a part of screening.
If, after this discussion, a man is unable to decide if testing is right for him, the screening decision can be made by the health care provider, who should take into account the mans general health preferences and values.
If no prostate cancer is found as a result of screening, the time between future screenings depends on the results of the PSA blood test:
- Men who choose to be tested who have a PSA of less than 2.5 ng/mL may only need to be retested every 2 years.
- Screening should be done yearly for men whose PSA level is 2.5 ng/mL or higher.
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.
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Should You Choose To Be Screened For Prostate Cancer At All
Prostate cancer is a disease that many men die with rather than of that is, despite aggressive prostate cancer killing some men, many more men would peacefully co-exist with their mild prostate cancers if they were left undiscovered.
Detecting prostate cancer might do good if it allows timely treatment to save mens lives, but can do harm via treatment side-effects: impotence, incontinence, the anxiety of false alarms or of discovering cancer, and so on.
Whether prostate screening saves lives at all is still debated. Several trials have found no preventive effect. The best-conducted trial showed that screening could prevent about one in five deaths from prostate cancer. However, this protection doesnt happen very often.
For a useful illustration, see the second page of this information sheet. This shows that over 11 years, about 1,000 men must be screened to save one life. In saving this one life, the trade-offs include:
- scores of men will have to undergo a prostate biopsy
- several will have complications of this biopsy
- about 37 extra men will find out they have prostate cancer
- several will suffer cancer treatment side effects such as impotence or incontinence.
How should we weigh up these pros and cons?
For some men, the small chance of benefit and the larger risk of harm leads them to decide not to proceed with testing. For others, the possibility of averting a cancer death, though small and uncertain, is worth the risks.
What Is A Prostate Screening
A prostate screening should be done routinely once a man turns a certain age. This in order to detect undiagnosed prostate cancer in someone who may not have any symptoms. There are two main tests that a man must undergo during a prostate screening: A PSA test and digital rectal exam. The PSA test checks the level of prostate-specific antigen in the blood. The digital rectal exam consists of the doctor feeling for any abnormalities within a mans prostate.
Both types of prostate screening tests are important to have because they test for different things. This means that complete confidence regarding the state of your prostate health requires both tests. As the most common cancer for men, it can be detected early and treated.
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What Does A Dr Do To Massage Your Prostate
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What Happens During Your Gp Appointment
Your doctor needs to build up a picture of what’s going on. So they will ask you some questions. These include:
- what symptoms you have
- when you get them
- whether anything makes them better or worse
They will ask you about your general health and any other medical conditions you have. They might arrange for you to have some tests.
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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.
Why Is Active Surveillancethe Wait
We utilize active surveillance for men who have been diagnosed with a low-grade prostate cancer. The reason we monitor low-grade prostate cancer using active surveillance, rather than treating it aggressively, is that there are cancers that dont need treatment.
With low-grade prostate cancer, youre more likely to have problems from the treatment than from the prostate cancer. Any treatment we do for prostate cancer is going to affect a mans urinary and sexual function. It may affect it a little bitor a lot. With this type of prostate cancer, we can tell you now that theres very little likelihood the cancer is going to cause you any problems. We have a good and growing amount of evidence that low-grade prostate cancers, on average, progress very slowly and do not appear to spread to the lymph nodes. Active surveillance lets us detect higher grade disease and treat it at that point.
For us to do anything and treat it is going to change your quality of life. I think thats a powerful thing.
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Do Doctors Still Perform Prostate Exams
Post-prostatic massage. In rare cases, your doctor might massage your prostate and test the secretions. Imaging tests. In some cases, your doctor might order a CT scan of your urinary tract and prostate or a sonogram of your prostate. CT scan images provide more detailed information than plain X-rays do.
Prostate Exams: Do You Really Need One
Prostate cancer, although the second most common cancer in men in the United States, is extremely treatable when it is detected in its early stages.
Recently, there has been debates in the medical community about whether or not the benefits of a prostate exam outweigh the risks. We asked Jeffery Spencer, MD, a Urologist at Finger Lakes Urology Institute for his expert opinion on prostate exams and prostate cancer screenings.
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When To Get A Prostate Cancer Screening
A prostate screening can help your doctor find prostate cancer early, but youll need to decide if the benefits of the exam outweigh the risks. Have a discussion with your doctor about prostate cancer screenings.
The U.S. Preventive Services Task Force now recommends that men ages 55 to 69 decide for themselves whether to undergo a prostate-specific antigen screening test, after talking it over with their doctor.
They recommend against screening for men at or above the age of 70.
The American Cancer Society strongly recommends that no one be screened without discussion of the uncertainties, risks, and potential benefits of prostate cancer screening.
They give these specific recommendations for the date at which these discussions with a healthcare provider should take place:
- Age 50 for men who are at average risk of prostate cancer and are expected to live at least 10 more years.
- Age 45 for men at high risk of developing prostate cancer. This includes African Americans and men who have a first-degree relative diagnosed with prostate cancer at an early age .
- Age 40 for men at even higher risk .
You should also speak with your doctor about a prostate exam if youre experiencing symptoms of a prostate problem, such as frequent or painful urination or blood in your urine.
After this discussion, if you decide to get a prostate cancer screening, the ACS and the American Urologic Association recommend getting a prostate-specific antigen blood test.
Are Prostate Cancer Screenings Recommended
Absolutely. Screening for prostate cancer is very important and recommended by the American Urology Association for men over 55 years old–age 40 if they are at higher risk. Prostate cancer is very treatable and early detection of prostate cancer is key to treatment and recovery.
Men should have a conversation with their primary care physician about their personal health to determine the best time for prostate cancer screening.
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