How Do I Get Ready For A Dre
You do not need to do anything special to prepare for a DRE. But there are a few things to keep in mind.
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Tell your health care team if you have hemorrhoids or anal fissures. The DRE may make them worse.
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If you are concerned about the cost of your DRE, find out from your insurance provider what costs they will cover beforehand. Ask how much of the cost you will have to pay out of pocket.
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You will be asked to sign a consent form before your DRE. The form will state that you understand the benefits and risks of the DRE and agree to have the test. Your doctor or nurse will explain the test before you sign the form, and you can ask questions.
Great News For Guys: No More Invasive Prostate Exams
Good news for all the over-40 men out there: we dont need routine screening for prostate cancer. More to the point, we dont need to subject ourselves to the dreaded digital rectal exam that has been a standard procedure for decades. Most guys dont need any encouragement to avoid this particular invasive procedure, but now theres good scientific evidence saying we dont need it.
One of the most widely used screens for prostate cancer is the PSA test. I wrote about this last year, after several studies and a thorough review concluded that
there is moderate certainty that the benefits of PSA-based screening for prostate cancer do not outweigh the harms.
Now, the Choosing Wisely campaign and the American Academy of Family Physicians have included not only PSA testing, but also digital rectal exams as procedures that are usually unnecessary. Their advice to physicians is very clear:
Dont routinely screen for prostate cancer using a prostate-specific antigen test or digital rectal exam.
So guys, the next time you go to the doctor, dont let him give you the PSA test or the dreaded digital rectal exam. If your physician hesitates , and hand it to him. If you or your doctor want to know more, the list includes references to long, detailed summaries of the evidence.
Choosing Wisely, which was created by the American Board of Internal Medicine Foundation, is a great idea: a campaign to educate patients and physicians about what practices are:
Are You Seeing Prostate Cancer Becoming More Prevalent In Younger Patients
Its pretty rare. Its less common that men in their 40s have prostate cancer, but, we also are very rarely screening them. The young men who come in to be screened tend to have one of those high-risk features. They most likely had a father who had prostate cancer, so theyre nervous about it. Or theyre African-American, and theyve been flagged by their health care providers.
If youre young, your quality of life is even more important to you right now. We know that, if diagnosed with low-grade prostate cancer, a person will need treatment at some time in life. If we can delay treatmentwhich could negatively impact urinary or sexual functionby several years, then we should do that and obviously discuss that there is a low but possible chance of metastasis developing during that time.
Also Check: What Is The Definition Of Prostate Gland
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.
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 anal fissures or hemorrhoids, as a DRE may aggravate these conditions.
If you decide to get 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.
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Common Treatment Options For Prostate Cancer
References:
Tests For Trans Women At The Gp Surgery
Your GP might give you a urine test, a PSA test and a prostate examination. They may then refer you to a urologist for more information and further tests if necessary. You can also discuss your concerns with a doctor at a gender identity clinic, who may refer you to a urologist.
PSA test in trans women
If youre a trans women over the age of 50, you can discuss your risk of prostate cancer with your doctor, even if you dont have symptoms.
Most experts think you should have a PSA test before starting feminising hormones or testosterone blockers if youre aged 50 or over, or over the age of 45 if you have a family history of prostate cancer or if you are black.
Its best to discuss your situation with your doctor as there are advantages and disadvantages of having tests.
Because feminising hormones, testosterone blockers and testicle removal can lower PSA levels, some experts believe that a PSA level above 1 ng/ml should be investigated further.
Prostate examination
Sometimes, a doctor will think its necessary to feel your prostate using a finger. If youre a trans woman or a non-binary person assigned male at birth who has not had any genital reconstructive surgery, or you have had a labiaplasty , youll have a digital rectal examination. This is where your doctor feels your prostate through the wall of your back passage .
If youve had genital reconstructive surgery that includes vaginoplasty then your prostate may be examined through the vagina .
Also Check: How To Treat Prostate Cancer That Has Spread To Bones
Can Women Have Prostate Cancer
Most people are aware that men can develop prostate cancer, but can women have prostate cancer? The answer is, Yes, sort of.
While women dont have a prostate gland, they have what are called the Skene glands . This group of glands and ducts is at the front of the vagina and is similar in some ways to the prostate, including that it contains prostate-specific antigen and PSA phosphatase , two enzymes that doctors use to assess the condition of the prostate in men.
Women can develop cancer in the Skene glands and, given the structures similarity to the prostate, the condition is sometimes referred to as female prostate cancer. Its extremely rare, but it can occur. One older study found that prostate cancer in women accounted for just 0.003% of all genital cancers.
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.
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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.
Can Women Get Prostate Cancer
Well, if women do have a prostate, can women get prostate cancer? There is a great discussion about the Skenes gland functions, anatomy, and roles. However, Female prostate cancer or Skenes gland cancer to be precise, is not common, rather its is rare to be found.
However, other urinary or gynecological medical conditions like skenes gland cysts, inflammation, and infections can be misdiagnosed. Women with symptoms like vaginal pain, lower urinary tract infection, urethras opening infection, hurting frequent urination or dysfunction in sexual activity, are advised to get evaluated by the doctor, in order to diagnose any kind of skenes gland infection.
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Why Not Bring The Entire Staff Into The Exam Room For My Prostate Exam
by Medical Justice | Feb 26, 2016 | Healthcare Reform |
I live in North Carolina. Each year I have a general physical exam. This includes the ritual known as the prostate exam. I dont particularly look forward to it. But, it takes a few seconds and Im reassured knowing that there are no lumps or bumps. My internist is male. And, in the exam room, its just the three of us my doctor, the electronic medical record, and me.
But, if I cross the border into Georgia for the same exam, the exam room may be more crowded.
The Georgia Composite Medical Board recently proposed new rules defining Unprofessional Behavior. One new rule, if adopted and enforced, would redefine unprofessional conduct to include:
Conducting a physical exam of the breast and/or genitalia of a patient without a chaperone present.
This Rule would replace the existing Rule 360-3-.02 which currently reads:
Conducting a physical exam of the breast and/or genitalia of a patient of the opposite sex without a chaperone present.
The pre-existing rule was not perfect. If a patient does NOT want another person in the room, it should be their right to keep the traffic down even if the examining doctor is of the opposite sex. The old rule is silent on whether the chaperone needs to the same sex as the patient. So, read literally, a male doctor could bring in another male staff-member to comply with the pre-existing rule for say, a gynecologic exam.
Now for the potential consequences of the proposed rule.
Do Trans Women Have A Prostate
Yes, trans women have a prostate the prostate is a gland that sits underneath the bladder and surrounds the urethra, which is the tube that carries urine out of the body.
The following people have a prostate:
- cis men
- non-binary people who were assigned male at birth
- some intersex people.
The prostate in cis men is usually the size of a walnut but increases in size with age. This increase in size is less if youre taking feminising hormones or drugs that prevent androgens like testosterone from having effects on the body .
Having male bits and pieces is not easy it is a nuisance but I have always accepted I am a trans woman. A personal experience
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Prostate : Info For Trans Women
by GenderGP | Feb 26, 2020 | Blog, Medical, Medical, Trans Feminine, Transgender |
The prostate is a gland in the male reproductive system that sits just under the bladder. The urethra passes through the prostate when it exits the bladder. It produces and releases a fluid that combines with sperm and seminal fluid to form semen.
As with any tissue or organ in the body, cells in the prostate can become cancerous. If you still have a prostate, you should be aware of the risk of developing cancer. This post aims to help improve your understanding of prostate cancer and how it relates to your transition.
Prostate cancer is reported as the most common cancer in UK males. However, there is very little research on prostate cancer in trans women. The available research suggests several things:
- Trans women have a prostate gland but it is often neglected
- It is easy to forget about something that has never caused you any trouble! Doctors can be nervous or anxious about talking to trans women about their prostate and sometimes trans women dont know about their prostate. If you experience any new symptoms that you think might relate to your prostate, see your healthcare professional for advice.
What are the symptoms of prostate cancer?
Prostate cancer causes the prostate to grow bigger. Due to where it is situated in the body, this can put pressure on the bladder and urethra giving rise to symptoms which become apparent when passing urine. These include:
The Paradox Of Being Male
Throughout the ages men have been taught that they must be strong, virile hunters, gatherers, and defenders of their families. Over time this societal mandate has ingrained a false sense of invincibilityone that seemingly exempts men from having to pay attention to their physical ills or see their doctors for annual checkups. The same pressure often leads them to feel extremely vulnerable and reluctant to discuss their self-perceived weaknesses when diagnosed with health problemsespecially those that lie below the belt.
When women are diagnosed with breast cancer, they go on the offensive, explains Jonathan Simons, MD, president and CEO of the Prostate Cancer Foundation , the worlds leading philanthropic supporter of advanced research for finding a cure. They open lines of communication with family and friends, they conduct extensive research, and they mobilize with pink ribbons and races. In contrast, too many men shut down and shut up. They are convinced that they can fight the battle alone. Its ironic. By doing so they are actually shirking their roles as protectors and contributing providers for their families and partners.
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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.