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How Often Should You Test For Prostate Cancer

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How Often Should Men Have A Prostate Screening

A prostate screening is extremely important to have regularly. Because, without them, a mans health is at a high risk of developing prostate cancer. Knowing how often prostate screenings should be had can be helpful to those men who are not sure.

A mans health is just as important to maintain as a womans. But most people are under the assumption that womens health needs more attention. However, that is not true. Men are at risk of developing prostate cancer, and it can become very problematic if not addressed.

Keep reading to find out how often a man should have a prostate screening.

What Do The Results Mean

PSA levels may be above the baseline for various reasons other than prostate cancer.

Other factors that can raise PSA levels include:

  • older age
  • an enlarged prostate â because of benign prostatic hyperplasia , for example
  • prostatitis, which is inflammation and swelling of the prostate

Also, people with obesity may have lower PSA readings.

In addition, some medications may reduce PSA levels, including:

  • 5-alpha reductase inhibitors, which can help treat BPH
  • aspirin, which some people take regularly as a blood thinner
  • statins, which help manage cholesterol levels
  • thiazide diuretics, a kind of water pill that can help reduce high blood pressure

Some herbal medicines and supplements can also lower PSA levels. Tell the doctor about any medications and supplements before undergoing the test.

High PSA levels alone do not indicate cancer. However, if a DRE also reveals changes, a doctor may recommend a biopsy for a more accurate result.

The PCA3 is another test for prostate cancer that doctors use in some circumstances. Find out more.

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.

During Watchful Waiting Or Active Surveillance

If you choose observation or active surveillance, your PSA level will be monitored closely to help decide if the cancer is growing and if treatment should be considered. 

Your doctor will watch your PSA level and how quickly it is rising. Not all doctors agree on exactly what PSA level might require further action . Again, talk to your doctor so you understand what change in your PSA might be considered cause for concern.

Itll Just Take A Minute

How Do Doctors Test for Prostate Cancer?

Theres 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, its over very quickly. The whole appointment might take just few minutes and the part youre dreading probably less than 20 seconds.

Youll 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 its natural to tense up in these situations, you be surprised at how easily a lubricated finger slips in. Once its in there it usually takes just a few seconds for the anal sphincter to relax around it.

Youll be aware of some pressing this shouldnt 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 Are The Guidelines For And How Were They Produced

The ‘Consensus statements on PSA testing in asymptomatic men in the UK‘ are a set of recommendations for health professionals. It contains a list of guidelines to help them better support men to decide whether or not to have a PSA test and when and how often this should happen.

Usually, experts look at the results of medical research to help them produce guidelines. But there havent been enough studies about the PSA test to give us all the answers. So until more results from research are available, we needed to get agreement from a large group of health professionals in order to write guidelines to fill some of the gaps. We asked more than 300 health professionals to tell us whether they agreed or disagreed with each guideline. We then made changes to the guidelines until the majority of the health professionals agreed with them. A smaller group of experts then met to talk about the guidelines and helped us produce the final version.

The consensus statements have been endorsed by the British Association of Urological Nurses , the British Association of Urological Surgeons and the Primary Care Urology Society .

We also spoke with men, including some men with prostate cancer and their partners, to find out what they thought about the guidelines, and whether they would help to support men.

This project was funded through charitable funds which were not provided by the pharmaceutical industry or any medical device or treatment company.

Why A Psa Test Is Done

A PSA test may be done to:

  • help find prostate cancer early in men who dont have any signs or symptoms of the disease
  • check for cancer in men who have signs or symptoms of prostate cancer
  • confirm a diagnosis when other tests suggest prostate cancer
  • predict a prognosis for prostate cancer
  • predict if cancer has spread outside the prostate
  • plan treatment for prostate cancer
  • monitor men with prostate cancer who are being treated with active surveillance
  • find out if cancer treatments are working
  • find out if cancer has come back after treatment

A PSA test is often used together with a digital rectal exam to increase the chance of finding prostate cancer early when it is easier to treat. Using these tests together is better than using either test alone.

Prostate Cancer Screening: Should You Get A Psa Test

Disclaimer: Results are not guaranteed*** and may vary from person to person***.

Theres no question the words prostate cancer screening invoke fear for countless men and their families. But is the prostate-specific antigen test really the best way to learn about the condition, or does it just cause an unnecessary stir in a peaceful life?

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.  

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.

What To Do If You Have Symptoms

Talk to your GP if you’re worried about symptoms or have noticed any unusual or persistent changes. 

  • Screening for prostate cancer 2013Cochrane Database of Systematic Reviews D Ilic, MM Neuberger, M Djulbegovic, P Dahm

  • Effect of a low-intensity PSA-based screening intervention on prostate cancer mortality: the CAP randomized clinical trial Richard M Martin PhD and othersJAMA, 2018. Volume 319, Pages 883-895

  • Mortality Results from a Randomized Prostate-Cancer Screening TrialGL Andriole and othersThe New England Journal of Medicine, 2009. Vol 360, Issue 13

  • Randomised prostate cancer screening trial: 20 year follow-upG Sandblom and othersBritish Medical Journal, 2011. Vol 342, Issue 1539

  • Prostate cancer risk management programme : benefits and risks of PSA testingPublic Health England, 2016

  • Screening and prostate cancer mortality: results of the European Randomised Study of Screening for Prostate Cancer at 13 years of follow-upFH Schroder and others

What Does The Psa Test Involve

The PSA test involves taking a blood sample and sending it to a laboratory for analysis. The results indicate:

Normal levels: Most healthy adult males have PSA levels below 4 nanograms per milliliter .

Borderline levels: PSA levels of 4â10 ng/ml are borderline. There is a 1 in 4 chance that cancer is present.

High levels: If PSA levels are over 10 ng/ml, there is a 50% chance that the person has prostate cancer. The specialist will likely recommend more testing, including a prostate biopsy.

It is important to note that PSA levels can naturally vary from person to person. A person with high levels may not have prostate cancer. On the other hand, about 15% of people who test positive for prostate cancer after a biopsy have PSA levels below 4 ng/ml.

Prostate cancer is not the only cause of high PSA levels. Find out more about the other causes here.

Who Should Have A Psa Test

What is the test for prostate cancer and when should you ...

Talk to your doctor about the PSA test. Make an informed decision about whether the PSA test is right for you by talking with your doctor and considering your personal risk factors.

  • If you are at average risk of developing prostate cancer, consider testing from age 50.
  • If you are at high risk of developing prostate cancer, consider testing from age 45. Black men and those with a family history of prostate cancer are considered to be at high risk.

Your PSA levels will determine how often you get tested. The decision to stop testing is based on your PSA levels, age and general health.

When Should Men Be Tested For Prostate Cancer

The U.S. Preventive Services Task Force recommends that men 55 to 69 may be screened for prostate specific antigens, a simple blood test that can indicate the possible presence of cancer in the prostate. Many doctors will recommend this as part of a regular physical exam for men. A digital rectal exam can be performed as well to feel for any abnormalities in the prostate. The American Cancer Society recommends screening for: men 50 and older who are expected to live 10 or more years; men 45 and older who are at high risk ; and men 40 and older who are at very high risk . It is up to the patient to decide to have the screening. If the PSA exam comes back lower than 2.5 ng/mL, the patient may be fine to wait two years for another check. If it is 2.5 ng/mL or over but there is no sign of cancer, another check should be done the next year. The USPSTF does not recommend screening for men 70 and older.

Living With Prostate Cancer

As prostate cancer usually progresses very slowly, you can live for decades without symptoms or needing treatment.

Nevertheless, it can affect your life. As well as the possible side effects of treatment, a diagnosis of prostate cancer can understandably make you feel anxious or depressed.

You may find it beneficial to talk about the condition with your family, friends, a family doctor and other men with prostate cancer.

Financial support is also available if prostate cancer reduces your ability to work.

Screenings Can Lead To High Costs

The cost for a PSA test is fairly lowabout $40.

If your result is abnormal, the costs start adding up. Your doctor will usually refer you to a urologist for a biopsy. Costs may include:

  • A consultation fee .
  • An ultrasound fee .
  • Additional professional fees .
  • Biopsy fees .

If the biopsy causes problems, there are more costs. You might also have hospital costs.

Prostate Exam Every 4 Years

The current guidelines of the American Cancer Society recommend that men over age 50 should be “offered” a prostate exam every year

The Story: A new European study has shown that a thorough screening for prostate cancer every 4 years is adequate. The screening comprises a PSA blood test, a digital rectal exam, and a transrectal ultrasound. “Very few, if any, aggressive prostate cancers escape screening….”

Prostate Cancer Screening Interval of 4 Years Misses Few Cancers, StudyShows

Linda Wang, AssistantNews Editor, Katherine Arnold, News Editor, Journal of the National CancerInstitute

A 4-year screening interval was adequate to detect most cancers ina large European randomized trial of prostate cancer screening, accordingto a study in the October 1 issue of the Journal of the NationalCancer Institute.

The European Randomized Study of Screening for Prostate Cancer is an ongoing randomized trial to determine the effect of screening on deaths from prostate cancer. Study participants randomly assigned to the intervention arm are screened every 4 years with a prostate-specific antigen test, a digital rectal exam, and a transrectal ultrasound exam. Little is known about the sensitivity, or the percentage of people who test positive for a disease amongpeople who have the disease, of these screening tests and theappropriateness of the 4-year screening interval.

  • MedicineNet
  • REFERENCES:

    Barbara K. Hecht, Ph.D., MedicineNet.com Editor

    Frederick Hecht, M.D., MedicineNet.com Editor

    Part 2 Of 2:checking Your Prostate

  • 1Robert Dhir, MDBoard Certified Urologist & Urological SurgeonExpert Interview. 23 September 2020. Though it may seem relatively simple to perform, prostate exams require proper technique and the ability to understand what you are feeling for.
  • Possible complications include bleeding due to nail punctures of cysts or other masses. This can lead to infection or other complications, which you cannot handle at home and would require a trip to your doctor regardless.
  • In addition, if your self exam is abnormal and you seek advice from your doctor, he will most likely repeat the exam to confirm the results anyway.
  • 2Assume the correct position. Performed at your doctors office, your doctor would position you either lying down on your side with your knees up or standing leaning forward with your hips flexed. This gives the doctor easier access to your rectum and prostate.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.
  • 4Put on a sterile glove. You or your partner should put on a sterile latex glove to perform the DRE. Ensure that you wash your hands before touching the glove to put it on. You will only use your index finger for the exam, but you should still wear gloves.
  • Use gentle pressure.
  • Need For This Guidance

    New Zealand men currently receive conflicting advice about prostate cancer testing and treatment. Some men may benefit from early diagnosis and treatment, but have limited opportunity to access appropriate health services.

    Unlike other cancers, prostate cancer often grows slowly. With routine prostate specific antigen testing, many men can be diagnosed with a cancer that is not going to progress during their lifetime. Such a diagnosis may increase mens exposure to unnecessary treatment-related harms.

    On the other hand, some men will still develop aggressive and potentially life-threatening prostate cancer. These men may benefit from prompt diagnosis and treatment.

    Should I Get Screened For Prostate Cancer

    This video helps men understand their prostate cancer screening options.

    In 2018, the U.S. Preventive Services Task Force made the following recommendations about prostate cancer screeningexternal icon

    • Men who are 55 to 69 years old should make individual decisions about being screened for prostate cancer with a prostate specific antigen test.
    • Before making a decision, men should talk to their doctor about the benefits and harms of screening for prostate cancer, including the benefits and harms of other tests and treatment.
    • Men who are 70 years old and older should not be screened for prostate cancer routinely.

    This recommendation applies to men who

    • Are at average risk for prostate cancer.
    • Are at increased risk for prostate cancer.

    Other organizations, like the American Urological Association,external icon the American Cancer Society,external icon and the American College of Physiciansexternal icon may have other recommendations.

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

    Prostate cancer symptoms: Doctors

    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.

    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 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 Is Prostate Cancer Treated

    For many men with prostate cancer, treatment is not immediately necessary.

    If the cancer is at an early stage and not causing symptoms, your doctor may suggest either “watchful waiting” or “active surveillance”.

    The best option depends on your age and overall health. Both options involve carefully monitoring your condition.

    Some cases of prostate cancer can be cured if treated in the early stages.

    Treatments include:

    Some cases are only diagnosed at a later stage, when the cancer has spread.

    If the cancer spreads to other parts of the body and cannot be cured, treatment is focused on prolonging life and relieving symptoms.

    All treatment options carry the risk of significant side effects, including erectile dysfunction and urinary symptoms, such as needing to use the toilet more urgently or more often.

    For this reason, some men choose to delay treatment until there’s a risk the cancer might spread.

    Newer treatments, such as high-intensity focused ultrasound and cryotherapy, aim to reduce these side effects.

    Some hospitals may offer them as an alternative to surgery, radiotherapy or hormone therapy.

    But the long-term effectiveness of these treatments is not known yet.

    What Is The Test For Prostate Cancer And When Should You Have A Screening

    Prostate cancer has overtaken breast cancer to become the third biggest cancer killer in the UK.

    In 2015, 11,819 men died from prostate cancer in the UK, compared to 11,442 women from breast cancer.

    However, while more women are learning to check their breasts, many men still dont know how the screening process for prostate cancer works.

    Contrary to many peoples beliefs, screening for prostate cancer is painless and relatively easy, so keep an eye out for symptoms and make sure to visit youre GP if youre worried. Better to be safe than sorry.

    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. 

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