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How Is A Prostate Exam Conducted

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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. 

What Happens After The Dre

If any abnormalities are found during the DRE, the doctor may order more tests and possibly schedule a prostate biopsy to see if there are any signs of cancer present.

If there are no signs of prostate cancer found during screening, the results of the PSA blood test may help to determine the time between future prostate cancer screenings. PSA levels vary by age and other factors.

Ultimately, you and your doctor will decide how often you should be screened since your diet, health and lifestyle habits are all factors on the timing and frequency of your prostate cancer screenings. Be sure to consult with your doctor if you notice any changes in your health.

What Do You Say To Patients Diagnosed With Prostate Cancer

Something I say to my patients a lot is that, in treating prostate cancer, we end up trying to extend your quantity of life at the cost of your quality of life. And so, at some point, if the quantity is extended a lot, and we can minimize the effect on quality, that makes sense, but the equation is different for every man. How much decrease in quality of life are you willing to accept if were going to extend your life?

Realistically, a lot of guys who are 70 dont have any sexual function anyway, so thats not a huge loss for them. As men get older theres definitely an increased chance of having erectile dysfunction ; the guys who have sexual function over 70 are very keen on preserving it. Even for the guys who dont have good sexual function, who are on Viagra, for them its often even more important to preserve what sexual function they have.

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 25 percent 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.

What Are Additional Tests For Detecting Prostate Problems

How A Doctor Performs A Prostate Exam

If the DRE or the PSA blood test indicates a problem may exist, the health care provider may order additional tests, including urinalysis, urodynamic tests, cystoscopy, abdominal ultrasound, transrectal ultrasound with prostate biopsy, and imaging studies such as magnetic resonance imaging or computerized tomography scan.

What To Expect During A Prostate Exam

The prostate sits near the bladder and is a walnut-sized gland in men that helps with the production of semen.

As you get older, your prostate can become enlarged or inflamed, and some men will develop prostate cancer. It’s the most common type of cancer in men, with almost 50,000 cases per year in the UK. Around eight in 10 men recover and live for at least 10 years after being diagnosed with it.

With many cancers, including prostate cancer, you may not notice any symptoms in the early stages. This means that the cancer can grow undetected and develop into a more serious stage or spread to other parts of your body.

Catching cancer early is one of the most effective ways to maximise your chances of making a full recovery. 

A prostate exam will help your doctor detect anything unusual happening with your prostate so that further investigations can be performed if needed.

Who Can Have A Prostate Orgasm

There’s a problematic yet persistent notion out there that you can’t be straight and enjoy butt play. This is falsea complete myth.

Anyone who has a prostate can potentially have a prostate orgasm, regardless of their gender identity or sexual orientation, says Dr. Justin Lehmiller, a research fellow at the Kinsey Institute, host of the Sex and Psychology Podcast, and member of the Men’s Health Advisory Board.

Questions To Ask Your Health Care Team

Before having a DRE, you may want to ask these questions:

  • Why do you recommend that I have a DRE?

  • What happens during the DRE?

  • Who will do the DRE?

  • How long will the DRE take?

  • Will it hurt?

  • Can a DRE find cancer?

  • When and how will I get my test results?

  • Who will explain them to me?

  • Will I need more tests, such as a colonoscopy or a barium enema, if the DRE suggests cancer?

How Are Prostate Problems Diagnosed

To diagnose prostate problems, the health care provider will perform a digital rectal exam . The health care provider will also ask the patient

  • when the problem began and how often it occurs
  • what symptoms are present
  • whether he has a history of recurrent urinary tract infections
  • what medications he takes, both prescription and those bought over the counter
  • the amount of fluid he typically drinks each day
  • whether he consumes caffeine and alcohol
  • about his general medical history, including any major illnesses or surgeries

Answers to these questions will help the health care provider identify the problem or determine what medical tests are needed. Diagnosing BPH may require a series of medical exams and tests.

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.  

How Is The Psa Test Used In Men Who Have Been Treated For Prostate Cancer

The PSA test is often used to monitor patients who have a history of prostate cancer to see if their cancer has recurred . If a mans PSA level begins to rise after prostate cancer treatment, it may be the first sign of a recurrence. Such a biochemical relapse typically appears months or years before other clinical signs and symptoms of prostate cancer recurrence.

However, a single elevated PSA measurement in a patient who has a history of prostate cancer does not always mean that the cancer has come back. A man who has been treated for prostate cancer should discuss an elevated PSA level with his doctor. The doctor may recommend repeating the PSA test or performing other tests to check for evidence of a recurrence. The doctor may look for a trend of rising PSA level over time rather than a single elevated PSA level.

What Happens During A Dre

The DRE will take place in a private exam room at your doctor’s office. The test only takes a few minutes. You will need to take off any clothes below your waist. You will be given a gown to wear or a cloth to wrap around your body.

For men. The doctor will ask you to stand and bend forward at the waist or they will ask you to lie on your side on an exam table with knees pulled up to your chest. As they start the DRE, the doctor may ask you to relax and take a deep breath. Then they will gently insert a lubricated, gloved finger into your rectum. The doctor will feel the size of your prostate gland. They will also feel for bumps, soft or hard spots, or other abnormal areas. The doctor will also examine the wall of your lower colon and rectum.

For women. The doctor will usually ask you to lie on your back on an exam table. Your feet will be in raised stirrups. The doctor may ask you to relax and take a deep breath as they start the DRE. Then they will gently insert a lubricated, gloved finger into your rectum. The goal is to feel your reproductive organs and the bowel. The doctor may also feel for problems in your internal organs. They do this by pressing on your lower abdomen or pelvic area with their other hand.

Should I Have A Prostate Cancer Screening Test

Prostate Exam

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.

Why Are Prostate Exams Performed

A lot of men do not realize the importance of a frequent prostate exam. When a man goes for a general check-up with his doctor, a prostate exam may be advised. This is considered part of a general health check-up. 

It is generally advised that men undergo frequent health screenings once they reach the age of 40 . Research shows that this is the time when the risk of several prostate conditions increases.

For this reason, after 40, a man should ensure they obtain a prostate exam as part of their health screening. 

The main reason why a doctor may advise on a prostate exam is to feel for any abnormalities with the mans prostate. This helps detect prostate disease. It is usually possible for a doctor to determine the health of the mans prostate through this examination. Further testing may be needed too. 

The doctor can detect different prostate problems through a prostate exam. It is often considered the initial diagnostic option. The prostate exam itself can give a doctor an indication if there is an enlargement or swelling in the prostate gland. It also helps to determine prostate health. 

In most cases, a prostate exam alone will not be the only diagnostic tool. After a digital rectal exam is done, the doctor will order additional tests if abnormalities are identified. This will help to diagnose problems like cancer and prostate enlargement. 

How Often Do I Need A Prostate Exam

July 31, 2020

Prostate cancer is one of the most common types of cancer in men, and its also highly treatable if caught early. There are a number of treatment options that have proven to be successful in combatting prostate cancer, even in its advanced stage.

Early detection is crucial because it gives you more treatment options and a better chance of eliminating cancer. The prostate-specific antigen test is used to check the PSA levels in your blood, and these levels are different for every man the indicator is whether the number is going up as compared to your prior PSA exam result. If your PSA is high the first time you have the test, your doctor may ask you to have a biopsy.

Similarly, your doctor will perform a digital rectal exam during your annual checkup to feel for any lumps or enlargement of your prostate. Lets talk about how often you might need to have a prostate exam and what you can expect.

Part 1 Of 2: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 & Wilkins.
  • Slow or weak urine streams
  • Difficulty urinating
  • Painful ejaculation
  • Lower back pain
  • A biopsy may also be necessary to confirm or rule out cancer.
  • What Do I Do If I Have A Rising Psa With A Negative Biopsy

    Unfortunately, some men find themselves in the frustrating and frightening position of having a continuing increasing PSA with negative biopsy results. Some of these men believe they have cancer and that the biopsy needle has simply missed it. Others are uncertain what to think. Most are confused how to proceed or what to do next. If your doctor is attempting to distinguish between prostate cancer and BPH, there are several additional factors relating to PSA that can be considered:

    What Is The Psa Test

    Prostate-specific antigen, or PSA, is a protein produced by normal, as well as malignant, cells of the prostate gland. The PSA test measures the level of PSA in a mans blood. For this test, a blood sample is sent to a laboratory for analysis. The results are usually reported as nanograms of PSA per milliliter of blood.

    The blood level of PSA is often elevated in men with prostate cancer, and the PSA test was originally approved by the US Food and Drug Administration  in 1986 to monitor the progression of prostate cancer in men who had already been diagnosed with the disease. In 1994, FDA approved the use of the PSA test in conjunction with a digital rectal exam to test asymptomatic men for prostate cancer. Men who report prostate symptoms often undergo PSA testing to help doctors determine the nature of the problem.

    In addition to prostate cancer, a number of benign conditions can cause a mans PSA level to rise. The most frequent benign prostate conditions that cause an elevation in PSA level are prostatitis and benign prostatic hyperplasia  . There is no evidence that prostatitis or BPH leads to prostate cancer, but it is possible for a man to have one or both of these conditions and to develop prostate cancer as well.

    Results And Follow Up

    After a DRE, your healthcare provider will know right away if there are any problems like lumps  or a prostate that is larger than usual . You will discuss any findings with your provider and plan the next steps. The results from a PSA test typically take around two weeks to come back, and your healthcare provider will go over these with you. 

    If all of your test results are normal, and you and your provider decide to continue screening, you will most likely need testing every two years. However, if the PSA test is abnormal, your healthcare provider may refer you to a urologist for additional testing. 

    How Do I Get Tested

    A general practitioner or an urologist can perform a full prostate cancer exam. This would usually include a PSA blood test and digital rectal exam, also called a DRE.

    A Prostate Specific Antigen 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 test 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, and 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 and subsequent 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.

    What Are Clinical Trials And Are They Right For You

    Age for Prostate Exam: When Should I Have One and How Is ...

    Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for you.

    What Is Screening For Prostate Cancer

    Some men get a PSA test to screen for prostate cancer. Talk to your doctor, learn what is involved, and decide if a PSA test is right for you.

    Cancer screeningexternal icon means looking for cancer before it causes symptoms. The goal of screening for prostate cancer is to find cancers that may be at high risk for spreading if not treated, and to find them early before they spread.

    If you are thinking about being screened, learn about the possible benefits and harms of screening, diagnosis, and treatment, and talk to your doctor about your personal risk factors.

    There is no standard test to screen for prostate cancer. Two tests that are commonly used to screen for prostate cancer are described below.

    It’ll Just Take A Minute

    There’s no shying away from the fact that this exam involves inserting a gloved and lubricated digit into the rectum. While that may not sound pleasant, it’s over very quickly. The whole appointment might take just few minutes and the part you’re dreading – probably less than 20 seconds.

    You’ll be granted some privacy to take off your lower clothing before being asked to lie on your side and draw your knees up to your chest. While it’s natural to tense up in these situations, you be surprised at how easily a lubricated finger slips in. Once it’s in there it usually takes just a few seconds for the anal sphincter to relax around it.

    You’ll be aware of some pressing – this shouldn’t be painful but it may make you feel a brief urge to urinate. If you do experience any pain you should tell the examiner straight away. If the exam is physically intolerable for you but deemed necessary it can be performed under general anaesthetic. Once the surface of the prostate has been inspected, the digit is removed and the area around the anus cleaned of any residual lubricant.

    What Kind Of Doctor Will I See For A Dre

    A primary care doctor or a gynecologist usually does a DRE. A gynecologist is a doctor who specializes in the health of women’s reproductive system. Other types of doctors, including gastroenterologists, surgeons, and oncologists may do DREs. A gastroenterologist is a doctor who specializes in the gastrointestinal tract. An oncologist is a doctor who treats cancer.

    Psa Density And Psa Density Of The Transition Zone

    PSA density is the level of PSA in the blood in relation to the size of the prostate measured during a transrectal ultrasound . It is calculated by taking the PSA level and dividing by the prostate volume. PSA levels are usually higher in men with enlarged prostates. PSAD can help doctors tell which men have prostate cancer and which men have benign prostatic hyperplasia because a high PSAD is more often related to prostate cancer.

    PSAD of the transition zone is the level of PSA in the blood in relation to the volume of the transition zone of the prostate. PSAD of the transition zone seems to be more accurate than PSAD of the entire prostate at identifying which men have benign prostatic hyperplasia and which men have prostate cancer.

    Can A Swollen Prostate If Untreated Cause Prostate Cancer

    We have no evidence of that. Theyre completely unrelated problems. The area of the prostate that causes urinary symptoms is usually a different part of the prostate than where cancer is likeliest to develop. 

    Doctors divide the prostate into different zones. The zone that is associated with BPHand the majority of prostate growthis the transition zone. Prostate cancer occurs there much less often than in the peripheral zone, which is the outer area. 

    The 2 Tests For Prostate Cancer You Should Know About

    There are 2 tests available to help detect prostate cancer early. If you and your doctor decide that the tests are right for you, have both of them .

    Prostate-specific antigen test

    A test is a blood test that measures prostate-specific antigen, a substance made by the prostate. The normal level of PSA changes as you get older. Higher levels of PSA can be caused by several prostate problems, not just cancer. Sometimes men with prostate cancer have PSA levels that are not higher than normal.

    The PSA test cannot diagnose cancer. It just indicates that there might be a problem with the prostate.

    The cost of PSA testing may or may not be covered by your provincial or territorial health system or your insurance.

    Digital rectal exam

    A is a physical examination of the prostate through the rectum. The doctor inserts a gloved finger into the rectum to feel the prostate for lumps or anything else that seems unusual.

    Both tests are better than one

    Using these tests together is better than using either test alone. PSA testing together with a DRE may help find a dangerous cancer early when it is easier to treat.

    Follow-up tests

    If a problem is found, more tests will be done to find out whether you have prostate cancer or another health problem. Further tests can include:

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