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.
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.
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.
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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.
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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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.
Preparing For A Prostate Exam
If you decide to get a prostate cancer screening, your doctor will likely order a blood test, so inform the person drawing your blood if youre prone to dizziness.
Your doctor may ask you to sign a consent form before performing a cancer screening.
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This examination lasts “15 to 20 seconds,” according to Ehdaie, and is “uncomfortable” but “not painful.” Rettig noted that on its own, the digital exam is “not going to add very much,” but can be paired with the blood test to give a full picture of the patient’s health situation.
After that exam is completed and the bloodwork is done, the results are “evaluated together.”
“A decision would be made to either pursue further tests because the screenings suggest there may be something that would be of concern, or they would return at the next scheduled ,” Ehdaie said.
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:
- 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
What Happens During A Digital Rectal Exam
Your health care provider will insert a gloved finger into the rectum and feel the prostate for hard, lumpy, or abnormal areas. The test takes only a few minutes to complete.
You may feel slight, momentary discomfort during the test. The procedure does not cause significant pain or any damage to the prostate.
When Should I Get A Prostate Exam
Prostate cancer screening tests have been considered standard practice in preventative care for middle-aged men for the last 30 years. One in every seven American men will develop prostate cancer at some point in his lifetime, and for a long while, general wisdom held that regular prostate cancer screeningsvia prostate exams or blood testswould help reduce health complications and death rates related to prostate cancer.
Given the long-standing prevalence of prostate cancer screening, men may therefore wonder: When should I get a prostate exam or blood test to screen for prostate cancer?
Recently, the answer to this question has become more complicated.
New Thinking in Preventative Screening
In healthcare terminology, screening refers to medical testing used to detect diseases and illnesses before the patient has shown any symptoms. Screening tests are used to safeguard against common diseases or diseases that the patient may be at higher risk of developing.
Preventative screening can be particularly important for people who are at high risk for certain diseases, such as prostate cancer. Cancer screening saves lives, since cancer treatment is most effective, and chances for curing the disease are highest, when diagnosed in the early stages.
Types of Prostate Cancer Screening
There are two tests used to screen for prostate cancer:
When should I get a prostate exam or PSA test? In determining the answer, men should consider both the benefits and risks.
Finding the Answer
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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.
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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Finding Prostate Cancer Early
There is no national screening program for the early detection of prostate cancer. Doctors have different opinions about whether all men without symptoms of prostate cancer should be tested.
There is concern that testing healthy men will cause unnecessary harm and lead to treatments that may not offer long-term benefits. Treatment for prostate cancer can leave men with side effects such as erectile dysfunction and continence issues, which can affect their quality of life.
Testing may identify fast-growing or aggressive cancers that have the potential to spread to other parts of the body and would benefit from treatment. It may also detect very slow-growing cancers that are unlikely to be harmful.
Weigh up all the risks and benefits before deciding whether to be tested for prostate cancer, particularly if you dont have symptoms. Talking to your doctor can help.
Prostate Cancer Screening Ages 40 To 54
The PSA test is a blood test that measures how much of a particular protein is in your blood. Its been the standardfor prostate cancer screening for 30 years.
Your doctor will consider many factors before suggesting when to startprostate cancer screening. But hell probably start by recommending the PSAtest.
While the general guidelines recommend starting at age 55, you may need PSAscreening between the ages of 40 and 54 if you:
- Have at least one first-degree relative who has had prostate cancer
- Have at least two extended family members who have had prostate cancer
- Are African-American, an ethnicity that has a higher risk of developing more aggressive cancers
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When Is It Time To Stop Being Checked For Prostate Cancer
Its essential to be fully informed about the potential risks of PSA testing, which includecomplications from biopsies and teratments.
The answer depends on your current health and your level of concern about cancer.
Routine PSA testing to check for prostate cancer is no longer recommended for most men. But despite what the experts suggest, many men continue to opt for annual PSA tests. This includes a surprisingly large number of men in their 70s. In a recent study in the journal Cancer, more than half of a group of men 75 and older had PSA tests and biopsies.
These men have placed their hope in the value of early diagnosis and treatment, yet stand to gain less from PSA testing than younger men. Across all ages, routine PSA screening leads to life-saving treatment for cancer in about one in every 1,000 men screened.
Force guidelines: These independent experts on preventive medicine do not recommend PSA screening for prostate cancer in men at any age, due to a lack of definitive evidence that the benefits of PSA testing are greater than the risks.
What Age Should Get A Prostate Exam
· 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
While the general guidelines recommend starting at age 55, you may need PSA screening between the ages of 40 and 54 if you: Have at least one first-degree relative who has had prostate cancer
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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.
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.
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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.