How Do Men Feel About The Rectal Exam
I think most men are willing to do it, but some men are exceptionally opposed to it. They might be happy to hear that there are studies ongoing in the United Kingdom looking at using magnetic resonance imaging as a screening tool to be able to avoid doing a digital rectal exam in the future. There is a large African immigrant population in London with a higher incidence of prostate cancerthey didnt want to have the prostate exam because they had a lot of opposition to it. They were uncomfortable with it.
What Is A Prostate Exam
A prostate exam is a screening method used to look for early signs of prostate cancer. In general, a prostate exam includes a PSA blood test and a digital rectal exam .
During the digital rectal exam portion, your healthcare provider carefully inserts their gloved finger into your rectum. This allows them to feel the edges and surface of your prostate gland to detect any potential abnormalities.
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 screening 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.
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What Is A Dangerous Psa Level
PSA levels are measured as a number of nanograms in each milliliter of fluid tested. This is written as ng/mL.
- PSA level 2.5 ng/mL or lower: This is a normal PSA level for those under age 60, but in some cases, prostate cancer may still be present.
- PSA level between 2.5 and 4 ng/mL: This is a normal PSA level for most people.
- PSA level between 4 and 10 ng/mL: This indicates that prostate cancer might be present. At this level, there is about a 25% chance that you have prostate cancer.
- PSA level 10 ng/mL or above: There is a 50 percent chance that prostate cancer is present. The higher the PSA rises above 10 ng/mL, the greater the chance that you have prostate cancer.
Your doctor may also monitor your PSA velocity, or doubling time, which means recording your baseline PSA the level at your very first PSA test and seeing how fast the PSA level increases over time. Rapid increases in PSA readings can suggest cancer. If your PSA is slightly high, you and your doctor may decide to keep an eye on your levels on a regular basis to look for any change in the PSA velocity.
Research Into Prostate Cancer Screening
Research is ongoing to find other prostate cancer screening tests and ways to improve the current test. This includes:
- new blood and urine tests
- a combination of a blood test and other information such as age and family history
- MRI and other types of scans
More research is needed to find out whether these tests are reliable enough to detect prostate cancer.
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Types Of Prostate Exams
There are two universal prostate screening methods, the PSA and DRE. The PSA, or Prostate-Specific-Antigen test, measures the amount of PSA in a mans blood. PSA is a protein produced by the prostate cells and constantly circulates through the blood.
The PSA has been controversial for misdiagnoses in the past, and the benefits of early detection must be weighed against false results. The test is highly sensitive and often detects a cancerous presence too small to be considered life-threatening. There is no standard PSA level. Some men with low levels have prostate cancer, while other men with high levels of PSA do not have cancer, hence the confusion over PSA test results. So, an upward trend in PSA readings over multiple tests suggests concern over the actual PSA level itself.
A digital rectal exam is where your urologist inserts a gloved finger into your rectum to palpate your prostate and check for any lumps and other irregularities. This quick and painless test can tell a lot about a mans prostate health.
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.
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Deaths From Prostate Cancer
Prostate cancer is the second leading cause of cancer death in American men, behind only lung cancer. About 1 man in 41 will die of prostate cancer.
Prostate cancer can be a serious disease, but most men diagnosed with prostate cancer do not die from it. In fact, more than 3.1 million men in the United States who have been diagnosed with prostate cancer at some point are still alive today.
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
American Cancer Society. Facts & Figures 2021. American Cancer Society. Atlanta, Ga. 2021.
National Cancer Institute. SEER Cancer Stat Facts: Prostate Cancer. Accessed at https://seer.cancer.gov/statfacts/html/prost.html on March 15, 2019.
Noone AM, Howlader N, Krapcho M, Miller D, Brest A, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA . SEER Cancer Statistics Review, 1975-2015, National Cancer Institute. Bethesda, MD, https://seer.cancer.gov/csr/1975_2015/, based on November 2017 SEER data submission, posted to the SEER web site, April 2018.
American Cancer Society. Facts & Figures 2021. American Cancer Society. Atlanta, Ga. 2021.
National Cancer Institute. SEER Cancer Stat Facts: Prostate Cancer. Accessed at https://seer.cancer.gov/statfacts/html/prost.html on March 15, 2019.
Last Revised: January 12, 2021
How Common Is Prostate Cancer
In the United States, the risk of a person with a prostate being diagnosed with prostate cancer is 11%. A persons risk of dying from prostate cancer is 2.5%, and the average age that a person is when they die from it is 80.
Your risk for prostate cancer increases if you:
- Are over the age of 50 years old
- Are African American
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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.
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What To Do If You Think You Are At Higher Risk Of Prostate Cancer
Speak to your GP if you think you are at higher risk of prostate cancer. For example if you:
- are a Black male or a Black person who has a prostate
- have a close relative, such as brother or father, who has prostate cancer
- have inherited certain genes which can increase the risk of prostate cancer
The risk of prostate cancer also increases as men get older.
The evidence so far suggests that routinely screening people who have a high risk of prostate cancer doesnt help prevent deaths. In fact, it might lead to men having treatment for prostate cancer even though that cancer wouldnt have caused any problems or symptoms.
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Early Cancer Detection Can Save Lives And Cut Treatment Costs But When Should You Start Having Prostate Exams And Do You Need To Have Them At All
When it comes to screening for prostate cancer, some men may be confused or apprehensive about beginning to get annual exams.
As prostate cancer affects one out of every six men, the American Cancer Society and other leading medical organizations recommend older men discuss having annual prostate cancer screenings with their primary care doctor to help detect the disease early. Early detection of the disease helps cure it in 90 percent of cases.
Generally, it is recommended that men with an average risk of prostate cancer start being screened with a digital rectal exam and PSA blood-level exam when they hit the age of 50. African-American men and men who have a father, brother or son who were diagnosed with prostate cancer when they were younger than 65 are at higher risk and should start screenings at age 40. Men who have had more than one of these close relatives diagnosed before age 65 are at even higher risk.
The size of the prostate changes with age: Its the size of a walnut in younger men, while its larger in older men. Other than skin cancer, prostate cancer is the most common cancer in American men. According to the American Cancer Society, this year about 161,360 new cases of prostate cancer will be diagnosed, and 26,730 men will die from the disease.
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 hasnt recommended rectal exams because there has yet to be a randomized trial in which some men get the rectal exam and some dont. 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. Its part of the evaluation that we use even if its 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 hasnt been studied, Dr. Freedland adds. Most people are screened with PSA and DRE.
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What If I Am Diagnosed With Prostate Cancer
Many people have been where you are standing. Dont lose hope. More than 3.1 million American men have been diagnosed with prostate cancer and are alive today.
The first thing you should consider doing is to find out about the specifics of your cancer. You should know your stage and grade .
From there you can find out what treatment options you want to pursue, if any. Talk to your doctors. Choose a healthcare team of different specialists, or consult a second opinion. You can also do your own research, or talk to men who have been in your position. Many of our advocates are patients and survivors hear their stories at the video library. Or head to the rest of our website to start some research.
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Importance Of A Prostate Exam In Detecting Prostate Cancer
As you get older, keeping up with your health becomes much more important. Thats why its vital to get the health screenings that can identify serious illnesses, perhaps long become they become severe cases.
For men, the most prevalent form of cancer is prostate cancer, with 3 million cases occurring in the U.S. every year. Fortunately, it can often be diagnosed early in men who undergo a prostate exam.
Weve asked Dr. Clark Wilson, a board-certified urologist at UT Health East Texas in Tyler, to answer some of the more common questions about prostate cancer.
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When To Get A Prostate Exam
Prostate cancer is a very common cancer in men who are 50 years of age or older. If detected early, the 10-year survival rate of prostate cancer is 98%. As a result, it is absolutely essential that you get a prostate exam at the correct time.
As previously mentioned, the ACS guidelines suggest that men who are 50 years or older should get screened for prostate cancer. However, for men who are at high risk of getting prostate cancer, this exam should be considered at age 45. Major risk factors for getting prostate cancer that might put an individual at high risk include:
- African American ethnicity
- A first-degree relative who was diagnosed with prostate cancer at an early age
If you have more than one first-degree relative that was diagnosed with prostate cancer at an early age, you should consider speaking with your healthcare provider even earlier, at age 40.
How Often Should You Get A Prostate Exam
How often should you get a prostate exam? Avoidance is always better than cure. We all know this thing very well, but how many of us are those who follow these things? As the age of a person increases, a lot of health related problems start to appear in his body.
The best way to avoid this is to have a medical screening and physical examination of your entire body at least once a year. An annual examination of the body does not only mean that diseases can be identified and treated, but whether all the organs of the body are functioning properly or not.
Routine annual check-ups are also called preventive care and help in symptomatic therapy. After any malfunction inside the body, the body gives a lot of signals which are easy to identify and diagnose on time. However, there are some tests that should be done after the age of 50.
Tests For MenBlood cholesterol test
A simple test and preventive measure assesses the condition of any type of heart disease you may have. This test shows the level of cholesterol and teryglycyride in the blood. Due to abnormal levels of cholesterol and triglyceride in the blood, the risk of heart attack and other types of heart disease increases many times.
How often should you get a prostate exam?
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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.
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Two Main Screening Tests
There are two tests commonly used to screen for prostate cancer:
- The Digital Rectal Exam : 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.
- The Prostate Specific Antigen Test: This exam measures the level of PSA in the blood. The levels of PSA in the blood are often higher in men who have prostate cancer. The PSA level may also be high in other conditions that affect the prostate.Usually, the higher the bloods PSA level is, the more likely it is that a prostate problem is present. But other factors, such as age and race, also can raise PSA levels. PSA levels also can be impacted by certain medical procedures, some medications, an enlarged prostate or a prostate infection.Since your PSA level may be high for other reasons, your doctor will need to interpret the test results.
If the results of the PSA and/or DRE suggest that you might have prostate cancer, your doctor will need to do a prostate biopsy to find out. This means a sample of your prostate tissue will be removed with a needle and sent to a lab, where a specialist will determine if it contains cancer cells.
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What Can Be Done If I Am Diagnosed With Prostate Cancer
There are many ways to treat prostate cancer. Some men with low-risk cancer will be placed on surveillance which means they do not get active treatment unless their disease progresses. This is an excellent option for many men.
For men with a more aggressive version of the disease located only in the prostate gland, the most common treatments are surgery and radiation therapy.
Other treatment options include high-intensity ultrasound, freezing of the prostate gland and radioactive seed placement into the prostate. For men with prostate cancer that is spread out beyond the prostate gland, the initial treatment is usually hormone injections and may include chemotherapy and oral medications.
If you would like to undergo a prostate cancer screening, please speak first with your primary care physician. You can also schedule an appointment with Dr. Clark Wilson, urologist with UT Health East Texas Urology in Tyler by calling 903-262-3900.
Dr. Wilson is fellowship trained in robotic surgery, has a particular interest in nerve-sparing robotic prostatectomy and has published extensively on the surgical management of prostate cancer.