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.
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This article was co-authored by Robert Dhir, MD. Dr. Robert Dhir is a board certified Urologist, Urological Surgeon, and the Founder of HTX Urology in Houston, Texas. With over 10 years of experience, Dr. Dhirs expertise includes minimally-invasive treatments for enlarged prostate , kidney stone disease, surgical management of urological cancers, and mens health . His practice has been named a Center of Excellence for the UroLift procedure, and is a pioneer in non-surgical procedures for ED using his patented Wave Therapy. He earned his undergraduate and medical degrees from Georgetown University and was awarded honors in pre-medical studies, urology, orthopedics, and ophthalmology. Dr. Dhir served as chief resident during his urological surgical residency at University of Texas at Houston / MD Anderson Cancer Center in addition to completing his internship in general surgery. Dr. Dhir was voted Top Doctor in Urology for 2018 to 2019, one of the top three Best Rated Urologists in 2019 & 2020 for Houston Texas, and Texas Monthly has named him to the 2019 & 2020 Texas Super Doctors Rising Stars list.wikiHow marks an article as reader-approved once it receives enough positive feedback. This article has 11 testimonials from our readers, earning it our reader-approved status. This article has been viewed 1,025,150 times.
What Would You Say To Men Who Dont Want To Get A Prostate Check
A rectal exam is recommended but optional. We recommend both, but if theyll just let you do a blood test, thats better than not doing anything at all. ;
If concern about the rectal exam is the only reason youre not getting screened, talk to your doctor about it. We can discuss the risks and benefits. None of the evaluation tests are mandatory, but the reason we do that is that it improves our ability to detect cancer. So, if thats why youre not being evaluated, we can talk and decide if we can do other tests.
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Understanding Your Psa Count
Prostate cancer is the second most commonly diagnosed type of cancer in men, with lung cancer being the first. So, its no wonder that many men routinely get their PSA level checked in their annual medical exam or if there appears to be a problem.
The PSA blood test looks for something called Prostate Specific Antigen, which is a type of protein primarily produced in the prostate gland. ; ;Though this test can be a valuable tool in the diagnostic process, it is not nearly as accurate at measuring cancer as many doctors lead patients to believe. ;For example, about two-thirds of all men who have what is considered an elevated PSA do NOT have prostate cancer. ;And, on the other side of the coin, about 20% of all men who are KNOWN to have prostate cancer have a normal PSA count!
The problem is that even though the PSA test has its failings, it is often treated as a perfect indicator of cancer. ;Be very careful to NOT fall prey to this widespread misunderstanding. ;The truth is that PSA levels are only an indirect measure of something happening in the prostate gland. ;Not a direct measure of cancer. ;And there is no normal or abnormal PSA level that applies to every man. ;This is because there are many factors that can affect the PSA count, cancer being just one of them.
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Dr. Behfar Ehdaie, a urologic surgeon specializing in prostate cancer at Memorial Sloan Kettering Cancer Center in New York, said that these varying guidelines are due to the different risk factors that each person faces. Things like family history, environmental factors, race and more can all come into play when it comes to assessing prostate cancer risk.
“There are specific patient level factors that have to go into that decision, including family history, comorbidities, and life expectancy,” said Ehdaie, who said that people who are not expected to live more than another decade may not be advised to get screened. “And of course, the patient’s own preferences are taken into account, their goals, what they want to achieve.”
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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.
When Should You Get Your First Prostate Exam
In 30 seconds
The answer to when you should get your first prostate exam depends on your medical history and genetic predisposition.
Your prostate grows throughout your life, which means youre more likely to experience problems as you age.
Prostate cancer is often symptomless, but if you feel unwell, consult a doctor: identifying whats wrong will help you get the right treatment.
First off, what is a prostate? This is a walnut-sized gland located below the bladder, near your rectum. It secretes fluid that becomes part of semen, helping to carry sperm. has two main growth phases; first in puberty, and the second from around age 25, continuing at a rate of; 14% increase each decade.
Sometimes the prostate can become enlarged enough to cause problems or as a result of related health issues. The most common prostate problems are:
- Prostatitis: when your prostate becomes inflamed as a result of an infection
- Benign prostatic hyperplasia : an overly enlarged prostate
- Prostate cancer
The recommended age for a prostate exam takes into account the fact the prostate grows throughout adulthood, but BPH, prostatitis and prostate cancer can affect you at any age. Below, well outline what to look out for, when to get a prostate exam, and what that entails.
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Whats The Recommended Age For Your First Prostate Exam
Starting at age 50, all men should discuss getting a prostate exam with their doctor.;
The reason for this is prostate cancer. In the UK, about one in eight men will be diagnosed with this in their lifetime. It mainly affects men aged 50 plus, but your risk increases as you get older, and the most common age to be diagnosed is between 65 and 69 years. Most men with early prostate cancer dont have any noticeable signs or symptoms.;
The exception to this rule is if you are experiencing symptoms, or if your genetics predispose you as higher risk. Doctors are increasingly finding the tendency towards some prostate cancers can be inherited from your fathers family. Additionally, black men are at a higher risk, with one in four getting prostate cancer in their lifetime.;
If youre experiencing no symptoms, heres the recommended age for prostate exam:
- If you have a family history, first prostate exam at age 40
- If you are black, first prostate exam at age 45
- If you have no family history and youre not black, first prostate exam at age 50
At What Age Should You Get Screened For Prostate Cancer
The following prostate cancer screening guidelines apply to men expected to live at least ten years.
Men ages 45 to 49 should have a baseline PSA test.
- If the PSA level is 3 ng / mL or higher, men should talk with their doctor about having a biopsy of the prostate.
- If the PSA level is between 1 and 3 ng / mL, men should see their doctor for another PSA test every two to four years.
- If the PSA level is less than 1 ng / mL, men should see their doctor for another PSA test between the ages of 51 and 55.
Men ages 50 to 59 should have their PSA level checked.
- If the PSA level is 3 ng / mL or higher, men should talk with their doctor about having a biopsy of the prostate.
- If the PSA level is between 1 and 3 ng / mL, men should see their doctor for another PSA test every two to four years.
- If the PSA level is less than 1 ng / mL, men should see their doctor for another PSA test at age 60.
Men ages 60 to 70 should have their PSA level checked.
- If the PSA level is 3 ng / mL or higher, men should talk with their doctor about having a biopsy of the prostate.
- If the PSA level is between 1 and 3 ng / mL, men should see their doctor for another PSA test every two to four years.
- If the PSA level is less than 1 ng / mL, no further screening is recommended.
Men ages 71 to 75 should talk with their doctor about whether to have a PSA test. This decision should be based on past PSA levels and the health of the man.
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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.
What Is A Prostate Screening
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.
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When Should You Check Your Psa Levels
Here are some guidelines on when you should check your PSA levels:
Under age 40: PSA screening is not recommended.
Aged 40-54: Routine PSA screening is not recommended.
Under age 55 at high risk: : The decision for screening should be individualized.
Aged 55-69: Talk to your health care provider about the benefits and risks of prostate cancer testing.
Aged 70 plus: Routine PSA screening is not recommended But men over 70 should talk to their health care provider about prostate cancer testing if they have any concerns.
Source: American Urology Association
PSA stands for prostate-specific antigen, a substance produced in the prostate. PSA levels are determined through a blood test. Elevated PSA levels may suggest the presence of prostate cancer. The test is not, however, prostate cancer specific.
It is essential that those who are thinking about prostate cancer screening are aware that the full screening involves a rectal examination by a physician who will evaluate the feel and texture of the prostate gland as well as a blood test that measures prostate specific antigen.
I often talk to my patients about the known limitations of PSA testing, particularly the fact that it is not cancer specific.
However, as prostate cancer is the most common cancer, and the number two cancer killer, of men, it is important to talk to your doctor if you have any symptoms of prostate cancer as well as to understand , PSA screening generally, and the shortcomings of the test.
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Dr. Matthew Rettig, the medical director of the Prostate Cancer Program at the Institute of Urologic Oncology at UCLA in California, said that even if screenings aren’t performed right away, men should at least start talking about them with their doctors early in life.
“I think I would have that conversation fairly early on in life, maybe even in 30s or 40s, about when to initiate screening,” said Retting. “I think that would be most important for patients who are at high risk for prostate cancer and high risk for early onset of prostate cancer. Those are the types of patients that probably ought to have the discussion and make a decision about when to start screening at a relatively young age.”
When To Get A Prostate Cancer Screening
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.
They recommend against screening for men at or above the age of 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.
They give these specific recommendations for the date at which these discussions with a healthcare provider should take place:
- Age 50 for men who are at average risk of prostate cancer and are expected to live at least 10 more years.
- Age 45 for men at high risk of developing prostate cancer. This includes African Americans and men who have a first-degree relative diagnosed with prostate cancer at an early age .
- Age 40 for men at even higher risk .
You should also speak with your doctor about a prostate exam if youre experiencing symptoms of a prostate problem, such as frequent or painful urination or blood in your urine.
After this discussion, if you decide to get a prostate cancer screening, the ACS and the American Urologic Association recommend getting a prostate-specific antigen blood test.
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