Prostate Exam Age: When Do You Need One
The prostate gland is essential for males.
It is essential to increase semen volume and facilitate the job of sperm cells.
It is located around the urethra, leaning against the rectum and below the urinary bladder.
Prostate problems are increasingly more common as we age.
They cause symptoms such as slow urinary stream, dribbling after urinating, increase in urinary frequency, urinary retention.
But when is the right time to start getting prostate exams?
Prostate Growth: A Normal Part Of Aging
Starting around age 25, the adult prostate begins to enlarge slowly. The condition is called benign prostatic hyperplasia , and it has nothing to do with cancer.
Itâs not clear why the growth happens. What is clear, however, is that around age 50, many men begin to have uncomfortable symptoms as a result of this enlargement. They may have to go to the bathroom more urgently and often, especially at night — and when they do, itâs often difficult to get a strong stream started or to empty the bladder.
This happens because the prostate gland surrounds the urethra, the tube that carries urine from the bladder and out through the penis. As the prostate grows, it compresses that tube, and that makes urination difficult.
If it gets so bad that you canât pee at all, thatâs a medical emergency. Get to an emergency room or call 911 immediately.
Who Should Get A Prostate Exam
Starting at age 50, all men should discuss prostate cancer screening with their doctor. The American Cancer Society advises men at higher risk to have this conversation at age 45.
Youre considered to have an increased risk if youre African-American or if a first-degree relative had prostate cancer before age 65. If more than one first-degree relative had prostate cancer before age 65, you might want to consider beginning prostate cancer screening even earlier.
The ACS estimates there will be about 180,890 new cases of prostate cancer in the United States in 2016. About 26,120 men will die from it.
Prostate cancer is easier to treat before it spreads. However, some prostate cancers are so slow-growing that they dont always require treatment. A lot depends on your age and other factors.
Discuss your risk factors with your doctor, and ask if you should have a prostate exam as part of your yearly checkup.
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What Age Should You Have Prostate Exam
Age 50
Beside that, how often should prostate be checked?
Your test results will further determine how often you may need a prostate exam. Generally, if your PSA result is under 2.5, you will likely only need to have the test every 2 years. On the other hand, if the result is higher than that figure, your doctor will likely recommend an annual prostate exam.
So anyway, how do you check your prostate? Doctors use the digital rectal exam as a relatively simple test to check the prostate. Because the prostate is an internal organ, your doctor cannot look at it directly. But because the prostate lies in front of the rectum, they can feel it by inserting a gloved, lubricated finger into the rectum.
Along with it, can I check prostate myself?
Besides an at-home PSA blood test, there is no easy way to test yourself for prostate cancer at home. It’s recommended to see a physician for a digital rectal exam, as they have experience feeling prostates for lumps or enlarged prostate.
Can you refuse a prostate exam?
What would you say to men who don’t want to get a prostate check? A rectal exam is recommended but optional. We recommend both, but if they’ll just let you do a blood test, that’s better than not doing anything at all.
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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.
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Is Going To The Bathroom Frequently A Sign Of Prostate Cancer
Thats one of the challenging things having urinary symptoms is very rarelyalmost nevera sign of prostate cancer. Having urinary symptoms means you should probably be evaluated for an enlarged prostate, also known as benign prostatic hyperplasia . We can treat your urinary symptoms and help you pee better.
If urinary symptoms bring men to the doctor, we can discuss screening for prostate cancer. Thats important because not all men will go to a doctor until theres something wrong with them. And prostate cancer screening really is the only way to detect prostate cancer, because its almost always asymptomatic.
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What To Expect During The Exam
You can get a prostate exam easily and quickly at your doctors office. Generally, for cancer screenings, your doctor will take a simple blood test.
Your doctor might also choose to perform a DRE. Before performing this exam, your doctor will ask you to change into a gown, removing your clothing from the waist down.
During a DRE, your doctor will ask you to bend over at the waist or lie on the exam table in a fetal position, with your knees to your chest. They will then insert a gloved, lubricated finger into your rectum.
Your doctor will feel for anything abnormal, such as bumps or hard or soft areas that might indicate a problem. Your doctor may also be able to feel if your prostate is enlarged.
A digital rectal exam can be uncomfortable, especially if you have hemorrhoids, but isnt overly painful. It will last only a couple of minutes.
A DRE is one of your doctors tools that can help them detect several prostate and rectal problems, including:
- BPH
- prostate cancer
- abnormal masses in your rectum and anus
Your doctor will be able to tell immediately if there are any areas of concern that may warrant further testing.
The results of a DRE exam are either normal or abnormal, but doctors typically rely on several different tests to help them make a prostate cancer diagnosis.
If your doctor feels something abnormal during the DRE, they will probably recommend getting a PSA blood test, if you havent done so already.
- transrectal ultrasound
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Prostate Growth And Sex
Urinary problems caused by BPH are known as lower urinary tract symptoms, or LUTS. Men with LUTS often have problems in the bedroom.
The link between LUTS and sexual problems is not fully understood. But many of these men have a lowered sex drive, trouble maintaining an erection, and theyâre less satisfied with sex. Depression, loss of sleep due to frequent nighttime trips to the toilet, or some related physical cause may play a role.
Whatever the reason, the worse LUTS get, the more trouble a man may have in the bedroom. LUTS can be treated, so see a doctor early, before the symptoms cause a bladder problem or begin to spoil your sex life.
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.
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Prostate Cancer Screening Faq
The American Cancer Society, along with other leading medical organizations, recommends informed decision-making when it comes to screening for prostate cancer. This means each man should make his own decision, along with his medical care providers, about whether to be screened.
Screening or testing to find a disease in people without symptoms can help find some types of cancer early, when its more easily treated. But for some men, the risks of prostate cancer screening may outweigh the benefits. Asking questions is an important step in deciding whether to be screened.
Q: What are the screening tests for prostate cancer?
A: There are 2 main screening tests for prostate cancer:
- The PSA test is a blood test to check the level of prostate-specific antigen in your blood. Most healthy men have levels under 4 nanograms per milliliter of blood. But everybody is different, and a lower PSA level doesnt guarantee a man is free of cancer, just like a higher level doesnt mean he has cancer.
- For the digital rectal exam , a doctor inserts a gloved, lubricated finger into the rectum to feel for any bumps or hard areas on the prostate that may need to be tested for cancer. This test may be done with the PSA or the PSA may be done alone.
Q: What if the results are not normal?
Q: At what age should I have my first screening test?
Q: Who is at higher than average risk for prostate cancer?
Q: Why shouldnt all men be screened for prostate cancer?
When Is A Psa Test Needed
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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If There Is A Family History Of Prostate Problems
If you have a family history of prostate problems, you may be at increased risk. You should, therefore, make sure you have regular checks in your 30s or 40sw upwards to reduce the risk of any problems arising. Make sure your doctor is aware of this family history so that he or she can provide advice and tips on getting your prostate checked. Many men do have a family history of prostate problems but they fail to go for regular checks, which then puts them at risk of developing issues that could otherwise have been avoided or tackled at an early stage.
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Rettig said that someone who has a strong family history of early onset prostate cancer might want to talk to their primary care provider or other health care practitioner earlier in life, while someone with less risk might prefer to wait.
The guidelines for how often men should be screened again also vary. If you have a high prostate-specific antigen , a protein made by cells in the prostate gland, you may be recommended to come back for more frequent screenings, but those with lower PSA levels might only be advised to come back every four years or so.
If youre 55 and have you have a PSA of less than one, you can wait four years to get screened again,Rettig explained. Alternatively, if youre 45 and have a PSA of two and a half, that might be someone who might get a biopsy or be re-screened within the year. How frequently one would be prescreened is really contingent upon the specifics of the patient.
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Prostate Cancer Screening Ages 55 To 69
This is the age range where men will benefit the most from screening.Thats because this is the time when:
- Men are most likely to get cancer
- Treatment makes the most sense, meaning when treatment benefits outweigh any potential risk of treatment side effects
Most men will get prostate cancer if they live long enough. Some prostatecancers are more aggressive others can be slow-growing. Doctors will takeyour age and other factors into consideration before weighing the risks andbenefits of treatment.
You should ask your doctor how often he or she recommends you get screened.For most men, every two to three years is enough.
Depending on the results of your first PSA test, your doctor may recommendyou get screened less frequently.
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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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.
Keeping Track Of Your Prostate As You Age
Prostate cancer is the second most common cancer diagnosed in men. Catching the disease in its early stages may improve a manâs chance of survival.
When you reach age 40, talk to your doctor about your familyâs medical history and other key factors that will help determine your risk of developing the disease.
If you get tested, youâll likely undergo a digital rectal exam and a PSA test, a blood-draw that measures your levels of prostate specific antigen . High PSA levels could indicate cancer, but they can also be caused by other conditions, including BPH. Talk to your doctor to make sure you understand what the results mean.
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Should You Get A Prostate Exam
Ideally, you should discuss the pros and cons of getting a prostate exam with your doctor.
Cancer screening has risks you need to understand before starting the process.
One of them is overdiagnosis and experiencing undesired side effects of prostate biopsies.
There are more risks than benefits in prostate exams for patients above 70 years.
Thats why they are often advised against screening.
After 55 years, patients with urinary symptoms should get screened.
Those with a family history of prostate cancer may also require screening .
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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.
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