What If A Screening Test Indicates The Possibility Of Prostate Cancer
If prostate cancer is suspected, a biopsy will be recommended. During this procedure, a physician inserts a hollow needle through the wall of the rectum to collect prostate tissue samples, which can be evaluated under a microscope for evidence of cancer.
Moffitt Cancer Center offers prostate cancer screening without referrals. To request an appointment with a specialist in our Urologic Oncology Program, call or complete a new patient registration form online.
What Do The Dre Results Mean
A digital rectal examination is a test used to see if you might have a prostate problem or prostate cancer.
Your prostate may feel:
- normal a normal size for your age with a smooth surface
- larger than expected for your age this could be a sign of an enlarged prostate
- hard or lumpy this could be a sign of prostate cancer.
The DRE is not a completely accurate test. Your doctor or nurse cant feel the whole prostate. And a man with prostate cancer might have a prostate that feels normal.
Medication For Urinary Problems
Your doctor may suggest various medications to help ease your urinary problems, including:
- medications to reduce the tone of the muscles of the urethra and prostate to minimise any constriction to urine flow caused when these muscles contract
- medication to reduce the size of the prostate gland. These medications work by blocking the action of male hormones produced by the prostate gland
- medications to relax the bladder, making unwanted contractions less likely and reducing the symptoms of urgency and frequency of urination
- the over-the-counter preparation saw palmetto is sometimes used. This may help some men, especially if frequent urination at night is a problem.
However, recent reviews of the evidence for using saw palmetto as a treatment for mild or moderate urinary symptoms did not show any improvement, compared to no treatment, in men with BPH.
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Prostate Exams To Screen For Cancer
There are two types of tests that healthcare providers use to screen for prostate cancer:
- A prostate-specific antigen test is a blood test that measures the amount of PSA in the blood. Sometimes, high levels of PSA are linked to prostate cancer.
- A digital rectal exam is a physical examination where a provider places their gloved finger into the rectum to feel the edges of the prostate gland.
It’s normal to feel nervous or even embarrassed about having a digital rectal exam . It will help to know what to expect during a prostate exam and understand why it’s so important to have one.
How Can You Prepare Yourself For A Prostate Exam
It takes little to prepare yourself for a prostate exam. Theres no need to change your bowel habits before youre due for the said exam. You can defecate before your appointment if you feel like doing so, and the exam itself will not increase your urge to move your bowels.
If everything checks out, then you only need to remember to come back for a follow-up prostate exam in the next 3 to 5 years. If the doctor detects anomalies in the digital rectal exam or if your PSA levels are abnormally high, however, you may be recommended to undergo further evaluation.
Prostate cancer is easy to treat before it spreads. In fact, about 99 per cent of all men who have been diagnosed with prostate cancer will survive for more than 5 years after their initial diagnosis. Early detection and treatment are key to this. If youre at risk for prostate cancer, then, dont hesitate to talk to your doctor about it and schedule an appointment to get your prostate checked. And if you have any concerns about the prostate exam, your doctor will gladly walk you through the process to help you feel more confident about undergoing this important and necessary evaluation.
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At What Age Should Men Get A Prostate Exam
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.
It recommends against screening for men at or above age 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.
The Prostate Cancer Foundation recommends that men practice precision screening, and consult with their doctor to come up with a personal prostate cancer screening plan thats right for them.
When to start this conversation depends on age and risk factors that may increase a mans risk of prostate cancer. Here are the general recommendations:
- Age 40: men who have a family history of prostate or other cancers in a first-degree relative, are Black, or have known genetic mutations that may increase the risk of cancers
- Age 45: men with no known risk factors
PSA screening should be considered carefully based on life expectancy, existing conditions, family history, and ethnicity. Side effects from some treatments can lessen life expectancy and quality of life.
A digital rectal exam may also be a part of your screening.
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.
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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 screening 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.
There is no standard test to screen for prostate cancer. Two tests that are commonly used to screen for prostate cancer are described below.
Screening For Prostate Cancer
Prostate cancer is typically treatable if caught early. More than 90 percent of prostate cancers are found when the disease is in the beginning stages, confined to the prostate and nearby organs.
Unlike screenings for breast and colon cancers, there are no universal screening guidelines for prostate cancer. The U.S. Preventive Services Task Force recommends that men age 55 to 69 weigh the benefits and risks before deciding whether they should undergo screening, which is typically performed with a blood test that measures levels of a protein called prostate-specific antigen .
However, men in high-risk groupssuch as those who are of African-American descent and/or have a first-degree relative diagnosed with prostate cancer before age 65should consider speaking with their doctor about starting screenings at an earlier age.
Men older than 70 shouldnt be routinely screened for prostate cancer, according to the USPSTF.
Regardless of age or risk factors, men should get checked if they suddenly experience issues with urination, erectile dysfunction or unexplained pain.
The USPSTF suggests that, before deciding on a screening, men should seek expert advice about the benefits and harms of screening. Risks may include:
- False positives
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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 the 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 people with prostate cancer, and the PSA test was originally approved by the FDA in 1986 to monitor the progression of prostate cancer in men who had already been diagnosed with the disease. In 1994, FDA approved the PSA test to be used in conjunction with a digital rectal exam to aid in the detection of prostate cancer in men 50 years and older. Until about 2008, many doctors and professional organizations had encouraged yearly PSA screening for prostate cancer beginning at age 50.
PSA testing is also often used by health care providers for individuals who report prostate symptoms to help determine the nature of the problem.
In addition to prostate cancer, several benign conditions can cause a persons PSA level to rise, particularly prostatitis and benign prostatic hyperplasia . There is no evidence that either condition leads to prostate cancer, but someone can have one or both of these conditions and develop prostate cancer as well.
How Accurate Is A Prostate Ultrasound
A prostate ultrasound is more accurate than an X-ray. This is because your technician can see the images as the transducer moves through your rectum rather than having to take a snapshot and develop the images. Ultrasound tests are also safer than X-rays because they dont produce any dangerous radiation.
A prostate ultrasound is also faster than a computed tomography test, which provides 3-D images of your prostate and the areas around it. CT scans require more preparation and time for testing, and they dont provide real-time images.
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What Should You Expect During A Prostate Exam
Its not unusual for patients to feel intimidated, scared, or embarrassed when going in for their first prostate exam, but rest assured that this is a routine exam for medical practitioners. Its perfectly fine to voice your concerns to your doctor so that they can adequately address any questions you may have about the procedure or the condition that you are being screened for. Before the digital rectal exam, a blood sample will be taken from you to assess the level of your PSA.
Upon being guided to the examination area, you will be asked to assume one of these positions: either lie on your side and hug your knees to your chest or bend at the waist while standing. Then, the doctor will gently insert a lubricated and gloved finger into your rectum. During this process, one of the doctors hands will be pressed on the prostate, while the other will be placed in the pelvic area. This can be an uncomfortable situation, but its usually not painful, and it only lasts a few moments.
The doctor will feel whether or not the back portion of your prostatethe part where many cancers start growinghas lumps or bumps. After the digital rectal exam, the doctor can tell you if your prostates shape and size are normal or if its enlarged or inflamed. A PSA, on the other hand, will reveal if you have a prostate infection.
The Test Is Often Not Needed
Most men with high PSAs dont have prostate cancer. Their high PSAs might be due to:
- An enlarged prostate gland.
- Recent sexual activity.
- A recent, long bike ride.
Up to 25% of men with high PSAs may have prostate cancer, depending on age and PSA level. But most of these cancers do not cause problems. It is common for older men to have some cancer cells in their prostate glands. These cancers are usually slow to grow. They are not likely to spread beyond the prostate. They usually dont cause symptoms, or death.
Studies show that routine PSA tests of 1,000 men ages 55 to 69 prevent one prostate cancer death. But the PSA also has risks.
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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.
A Look At Prostate Cancer
Although some prostate cancers can grow quickly and aggressively spread to neighboring tissues, most cases of prostate cancer involve slow growth that is confined to the gland . In fact, some men may not even know they have prostate cancer until they have been tested or examined for other health problems.
Part of that comes from the symptoms of prostate cancer or lack thereof. In its early stages, prostate cancer typically presents no symptoms, or the symptoms may be so minimal that you donât even notice . More advanced forms of prostate cancer may cause:
- Reduced pressure when urinating
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How Is The Psa Test Used In Men Who Have Been Treated For Prostate Cancer
The PSA test is used to monitor men after surgery or radiation therapy for 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 the recurrence causes symptoms.
However, a single elevated PSA measurement in someone who has a history of prostate cancer does not always mean that the cancer has come back. Someone who has been treated for prostate cancer should discuss an elevated PSA level with their 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.
A rising trend in PSA level over time in combination with other findings, such as an abnormal result on imaging tests, may lead the doctor to recommend further cancer treatment.
What Is It Used For
A PSA test is used to screen for prostate cancer. Cancer screening means looking for signs of cancer before it causes symptoms. But screening tests can’t diagnose cancer. If a screening test finds signs of cancer, you’ll need other tests to find out if you have cancer and how serious it may be.
Most types of prostate cancer grow very slowly. They don’t spread beyond the prostate and may never cause health problems. In fact, you can live a long life with prostate cancer and never know you have it. The goal of prostate cancer screening is to help find cancers that may be more likely to spread so they can be treated early. But there are challenges and possible harms from using a PSA test to screen for prostate cancer:
- A PSA test can’t tell the different between abnormal PSA levels from prostate cancer and noncancerous conditions. If your PSA level is high, a prostate biopsy is the only way to find out if the cause is cancer. And prostate biopsies have possible harms.
- A PSA test may lead to finding and treating prostate cancer that would never have affected your health. If prostate cancer is found:
- It can be difficult to tell the difference between slow-growing cancers and those that are likely to grow faster and spread in your body.
- You could have prostate cancer treatment that you never really needed. And cancer treatment may cause serious harms, such as:
- Problems controlling your bowels
PSA testing may also be used to:
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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.
Further Tests For Prostate Cancer
If results of the PSA test or the DRE are abnormal, a urologist will likely recommend a biopsy, where small samples of tissue are removed from the prostate and examined.
If cancer is diagnosed, other tests may be used to check the progression of the cancer, including:
- magnetic resonance imaging scan of the prostate â often done before a biopsy
- bone scanâ to check whether or not cancer cells have spread to the bones
- computed tomography scan â a specialised x-ray
- pelvic lymph node dissection â a nearby lymph node is removed and examined to check whether or not cancer cells have entered the lymphatic system .
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