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Is A Prostate Exam Necessary

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What Is A Prostate Screening

Prostate health and the dreaded prostate exam.

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.

Better Together: A Psa Test And Digital Rectal Exam

PSA is a protein thats created by the prostate and present in semen. Small amounts of PSA naturally leak out into the bloodstream, but a higher-than-normal amount of PSA in the blood can indicate that a man may have prostate cancer. An elevated PSA level also can be sign of prostatitis or an enlarged prostate .

When one of my patients has a high level of PSA in his blood, a DRE helps me understand and interpret whats really going on inside the prostate. By feeling for any lumps or signs of cancer in the prostate, the rectum or nearby organs, I can get a better idea of whether my patient has prostate cancer, an enlarged prostate, or another condition. The combination screenings of PSA and DRE can tell us whether we need to move forward with more-invasive testing, such as a prostate biopsy.

How Would You Say Prostate Orgasms Differ From Penile Ones

Fred: Theyre way more intense. Penile orgasms are quicker, and they dont feel anywhere near as good. I love both, naturally, but for me, a penile orgasm is a quick release, whereas getting a prostate orgasm is a full eyes rolled back situation.

Alan: The obvious answer for me is the different location of the sensations. Oftentimes, with prostate orgasms, I have engaged my entire body. On top of that, it doesnt have to mean an ejaculation, thus changing how we define what the climax of our sexual pleasure is. I often find, depending on the situation, that I can have sex longer with a prostate orgasm.

Evan: Prostate orgasms are a lot more full-body. I feel it more in my legs and torso, rather than just locally in my dick. Also, sometimes I cum kind of quickly from penile orgasms, and with prostate stimulation, I last longer in every way. The resulting orgasm is generally longer and âslowerâ than just stimulation from my dick.

Drew: In my experience, p-spot orgasms are really different from penile ones. When I cum via penile stimulation it feels like a quick and heavy punch to my pleasure center, followed by a really nice burst/release prostate orgasms are much more intense and drawn out. At some point, I usually start oozing cum , which can go on for quite a while. I liken this all to an ocean wave on the beach, undulating between crashing up the shore and receding back down to the sea, only to come back once more.

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What Is A Prostate Cancer Screening Like

A prostate cancer screening can be conducted in one of two ways. The first, a PSA test, is a simple blood draw. The second is a brief rectal exam that takes less than 30 seconds to perform.

For a screening, if a patient comes and asks for a prostate cancer screening, it begins with a blood test, said Ehdaie. Its a small vial of blood, and then a medical history and physical examination. In the physical examination there will be a digital rectal examination in which the physicians finger is inserted into the rectum to feel the prostate.

Should I Get Screened

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Diagnostic tests for prostate cancer are recommended for any man who has symptoms of prostate cancer, such as pain or changes in urination. Men over the age of 50 who have no symptoms sometimes undergo screening tests. In May 2012, the U.S. Preventive Services Task Force recommended against prostate-specific antigen screening tests for men of any age.3 However, in May 2018, the Task Force revised their recommendation, stating that men ages 55-69 years old should talk to their doctor about the potential benefits and harms of PSA screening. The USPSTF continues to recommend against PSA screening in men ages 70 and older.4

What about other methods of screening, like digital rectal exams, which are usually done together with PSA testing? The Task Force continues to conclude that they tend to do more harm than good.

The U.S. Preventive Services Task Force is an independent group of medical professionals that reviews all evidence on preventive health care services. It adopted its current position after expressing doubts about the value of prostate cancer screening for several years. In 2008, the Task Force said screening was not recommended for men over 75, but wasnt sure about its value for men younger than 75.5 In 2009, the American Urological Association issued new guidelines saying that annual screening was no longer recommended.6

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Surprising Prostate Cancer Statistics

2020-07-3030 July 2020

Prostate cancer is common, but did you know that its the second most common cancer diagnosed in American men? Here are eight other surprising prostate cancer statistics, according to the American Cancer Society:

  • Prostate cancer is the second most common cause of cancer death in American men.
  • 1 in 9 men will be diagnosed with prostate cancer.
  • Prostate cancer has race-related risk factors and is diagnosed more frequently in African American men.
  • Men under 40 are rarely diagnosed with prostate cancer.
  • More than half of prostate cancer diagnoses are men who are 65 or older.
  • The average age of diagnoses is 66.
  • This year, 200,000 new cases of prostate cancer will be diagnosed.
  • 34,000 men will die from prostate cancer this year.

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Another Option: Digital Rectal Exams

Most prostate biopsies are driven by PSA results. Urologists also use the digital rectal exam, or DRE.

“The American Urological Association hasn’t recommended rectal exams because there has yet to be a randomized trial in which some men get the rectal exam and some don’t. Based on who lives and dies, this would show if rectal exams have value,” says Dr. Freedland. “Many people, myself included, think they do have value. It’s part of the evaluation that we use even if it’s not officially in our guidelines.”

The DRE may cause momentary discomfort, but it can also detect prostate cancer for those patients with normal PSA levels. “We use the exam because we think it should work and be helpful, even if it hasn’t been studied,” Dr. Freedland adds. “Most people are screened with PSA and DRE.”

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What Are The Symptoms Of Prostate Cancer

If you notice any of the following symptoms, please see your doctor immediately.

  • Erectile disfunction or other irregularities. If youre suddenly experiencing erectile dysfunction or having trouble performing sexually, it could be a sign of Prostate cancer.
  • Blood in urine or semen. If theres any pain or burning sensation while urinating or you find blood in your urine or semen, please consult you doctor at once.
  • Frequent urination. If you notice that youre urinating much more frequently, its worth discussing it with your doctor to find the probable cause.
  • Any changes to your urination pattern, such as a weak flow, dribbling after urination or bladder obstruction need to be checked out as well.

As men age, the prostate can become enlarged and lead to some of the above problems. If you notice any of the above-mentioned symptoms, please do not panic. Go see your doctor to get your Prostate checked to rule out cancer.

When Is A Psa Test Needed

Is PSA Testing Necessary?

If you are age 50 to 74, you should discuss the PSA test with your doctor. Ask about the possible risks and benefits.

Men under 50 or over 75 rarely need a PSA test, unless they have a high risk for prostate cancer.

  • You are more likely to get prostate cancer if you have a family history of prostate cancer, especially in a close relative such as a parent or sibling.
  • Your risks are higher if your relative got prostate cancer before age 60 or died from it before age 75. These early cancers are more likely to grow faster.
  • If you have these risks, you may want to ask your doctor about getting the PSA test before age 50.

This report is for you to use when talking with your healthcare provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.

04/2014

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Experts In Urology Care

If you are experiencing symptoms consistent with urinary issues, we urge you to complete our urologic cancer risk assessment form.

Not everyone should get a PSA test. Why? Because many men in this country are treated for low-risk prostate cancer that is discovered through the PSA test, even when it is unlikely that the disease will ever cause symptoms or lead to death. And treatment is associated with significant side effects, including impotence and incontinence . So a PSA test is recommended only for men who might be at greater risk for dying of prostate cancer for example, younger men with a family history of prostate cancer or African-American men.

To avoid the risks of over-treatment, Roswell Park follows the guidelines established by the National Comprehensive Cancer Network . The NCCN brings together world-renowned experts from 30 of the nations top cancer centers to write guidelines that specify the best ways of preventing, detecting and treating cancer. The guidelines are updated at least every year, on the basis of the latest research.

Michael Kuettel, MD, PhD, MBA, Chair of Roswell Park’s Department of Radiation Medicine, serves on the NCCN Prostate Cancer Panel.

The NCCN recommends that only men in these categories receive a PSA test for early detection of prostate cancer:

Whats The Best Treatment For Prostate Symptoms

Treatments for prostate cancer include surgery to remove the prostate, radiation therapy, and ablation therapies, as well as active surveillance. Some treatments are better for some men and some prostates than others. There are side effects for each, so it really requires an informed discussion to help each man make an educated decision.

One thing we do at Yale is use an MRI of the prostate to evaluate the location of the prostate cancer for surgical planning. Ive found it to be quite helpful. Its not done everywhere.

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Ways To Perform Self Prostate Exam For Most Common Prostate Diseases

How do you perform self prostate exam? Do you know that you have got a problem with your penis? The answer is not very clear.

You can insert your finger, as described in my own page of self prostate massage, you may have some ideas, but not sure. It should be soft and not hard, painless soft touch, and feel smooth without caking. Make sure you use gloves and lubricate to make insertion easier. To be gentle!

DRE or digital rectal examination by a trained urologist will provide you with the information you need. He would be very hesitant if he wants to do a biopsy. This is because the procedure has a lot of risks. He may underestimate the path of the invasion including the act if he finds the slightest sign of cancer.

Due to prostate disease symptoms often have no specificity, which means that prostate disease is difficult to distinguish only from the symptoms. So when you have these symptoms, you should also check through many other exams to finally determine whether it is really a prostate disease. It is best to get aids from professional hospitals as soon as possible to find a solution. Urinary problems can warn male urinary system, including many organs, such as lower urinary tract, the bladder, prostate and urethra, they have directly relations to the appearance of urinary symptoms.

What Is The Prostate

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The prostate is a small gland in the pelvis, found only in men.

About the size of a satsuma, it’s located between the penis and the bladder, and surrounds the urethra.

The main function of the prostate is to produce a thick white fluid that creates semen when mixed with the sperm produced by the testicles.

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Can’t I Just Get A Blood Test

If you have concerns about prostate cancer you certainly should have a Prostate Specific Antigen blood test. Knowing your PSA level can help to establish what’s normal for you so that a spike is more easily identified. But a blood test alone is not enough. The test has been known to deliver ‘false-positive’ results in some cases – leading men into have invasive biopsies for no reason. Up to 20% of men with prostate cancer show no increase in PSA levels*. So it’s best used to check against the result of a rectal exam but can’t be relied upon in isolation.

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.

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When Do You Need A Prostate Exam

PSA is continuously present in the bloodstream for most men, and an increase in its number may be attributed to causes other than cancer. However, men who have an increased risk of prostate cancer should undergo a regular prostate exam.

Age, family history, and race are all possible factors that can increase your risk. Likewise, your doctor may also recommend that you undergo testing if you are experiencing discomfort or pain while urinating.

Symptoms which may indicate that you have a prostate issue include the following:

  • Inconsistent flow of urine

How Often Is a Prostate Exam Necessary?

Your frequency of testing may be due to several factors, including your age and present health condition:

Do You Also Ejaculate When You Have A Prostate

Is the PSA Test Necessary?

Fred: Sometimes yes, sometimes no. Occasionally Ill shoot when Ive gone through a prostate orgasm, but usually, if I ejaculate, I dont even notice.

Alan: Most of the time I do ejaculate with a prostate-induced orgasm, but the first time I didnt. Its how I learned I could climax without an ejaculation.

Drew: I generally cum from p-spot orgasms, but itâs more drawn out and less of a âshooting my loadâ type situation. The cum oozes out during the drawn-out orgasm and is usually accompanied by some really lovely spasming of my hole.

Oh boy, do I ever. I have been told on multiple occasions that I need to do adult film work with the amount that I ejaculate when my prostate is stimulated. Fountain, hose, shower, drain spoutjust a few of the words that humans have used to describe my cumshot when something is up my rear end.

Daniel: Many times when Iâm enjoying prostate stimulation itâs difficult to keep an erection. I get lost in the waves of pleasure and just lose it. Other times, I can maintain my erection and will masturbate while being penetrated or stimulated. I can time my prostate orgasm with my penile one causing a massive surge of energy and triggering dopamine to leak in my brain.

Dominus: I practice Tantra and can have multiple body orgasms that arenât ejaculatory, and prostate play can get me to that state. Now if I want to ejaculate at the same time, at my age, this is the only time I really shoot like I did in my teen years.

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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.

Types Of Prostate Cancer Screening: Psa Blood Tests And Digital Rectal Exams

Prostate cancer occurs when cells create small tumors in the prostate gland, which is an important part of the male reproductive system. Screening can be performed quickly and easily in a physicians office using two tests: the prostate-specific-antigen blood test, and the digital rectal exam , a manual exam of the prostate area.

Most screening tests are not 100% accurate, but these prostate tests are especially inaccurate. Most men with a high PSA level do not have prostate cancer , and some men with prostate cancer have a low PSA level . The DRE also results in many false positives and false negatives. Using both screening methods together will miss fewer cancers but also increases the number of false positives, which can lead to more testing and possibly result in medical complications. A biopsy to determine if there is a cancerous growth in the prostate involves inserting a needle, usually through the rectum, to remove a small sample of prostate tissue.

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