What Is A Prostate Exam
The prostate exam, or digital rectal exam , allows your healthcare provider to check on the health of your prostate gland. Some providers have used it as an element of prostate cancer screening.
After reviewing several studies, experts now recommend against using the prostate exam in prostate cancer screening because the DRE may not be effective for prostate cancer screening. However, many healthcare providers still use it for other purposes or combined with the PSA test for prostate cancer screening .
The prostate gland sits just in front of the rectum. Your healthcare provider can reach it by gently inserting a finger in the rectum via the anus. Theyll manually feel your prostate to look for larger than usual areas, lumps, hard spots, tenderness, or any other problems. While performing the DRE, the healthcare provider can also check for other issues in or around the rectum, like hemorrhoids, anal fissures, blood in the stool, etc.
Deciding If You Need A Prostate Screening
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.
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Prostate Exams: Do You Really Need One
Prostate cancer, although the second most common cancer in men in the United States, is extremely treatable when it is detected in its early stages.
Recently, there has been debates in the medical community about whether or not the benefits of a prostate exam outweigh the risks. We asked Jeffery Spencer, MD, a Urologist at Finger Lakes Urology Institute for his expert opinion on prostate exams and prostate cancer screenings.
What Do The Dre Results Mean
A digital rectal examination is a test used to see if you might have a prostate problem or prostate cancer.
Your prostate may feel:
- normal a normal size for your age with a smooth surface
- larger than expected for your age this could be a sign of an enlarged prostate
- hard or lumpy this could be a sign of prostate cancer.
The DRE is not a completely accurate test. Your doctor or nurse cant feel the whole prostate. And a man with prostate cancer might have a prostate that feels normal.
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When To Startand Stopscreening
The doctors and researchers who recommend screening argue that cases of prostate cancer found very early can be cured more quickly, with less chance of relapse or spread. Those who recommend against routine screening point to the slow-moving nature of prostate cancer and the side effects of surgical and medical treatment, which can be considerable.
The introduction of PSA screening in the US led to an initial increase in the number of prostate cancer cases diagnosed each year, even though many of these new cases were non-aggressive or low-risk prostate cancer. The issue was not that screening was harmful, it was that many of these low-risk cancers did not necessarily need immediate treatment. It seems strange to say that a patient might be better off leaving cancer untreated, but in some cases, it can be true. For a few years, the United States Preventative Services Task Force recommended against PSA screening. We are now seeing more cases of advanced prostate cancer diagnosed in recent years. This may be a long-tail effect of that USPSTF recommendation. It has now been changed to note that for men aged 55 to 69 years, the decision to undergo PSA screening is an individual one and should be discussed with your doctor. USPSTF continues to recommend against screening for men aged 70 and over.
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
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Why Should I Get Both Prostate Cancer Screenings
Both screenings provide valuable information about your health that can detect prostate cancer, even at an early stage. One result without the other may not provide enough indication of whether or not treatment is necessary.
There are many reasons why a mans prostate may be enlarged, and prostate cancer is only one. When paired with a PSA blood test, results can better indicate whether further testing is needed to determine a diagnosis.
What To Expect During A Prostate Exam
The prostate exam, or digital rectal exam , along with prostate-specific antigen testing, is sometimes part of the prostate cancer screening process. Recent research suggests that the DRE may be ineffective in prostate cancer screening. Current screening recommendations vary depending on age and other factors. Men aged 5569 should talk with their healthcare providers regarding their risks and benefits of prostate cancer screening. African Americans and men with a family history of prostate cancer may need early screening.
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What Do You Want Men To Know About Prostate Cancer
The important thing to know is that, if you live long enough, you will probably get prostate cancer. If you live into your 80s, about 80 percent of men have some sort of prostate cancer. That doesnt mean theyre going to die from prostate cancer because, as a percentage, very few men die from prostate cancer. It means its important to be aware of it and consider screening early, so if its a high-grade type, we can identify it and treat it.
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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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.
Prostate Exam In Concord Mint Hill And Charlotte
Some men are hesitant about getting tested, but a skilled urologist will give you confidence and knowledge about maintaining your prostate health. Dr. Richard Natale is here to help you maintain optimum sexual health and overall health as well.
If you have any questions or would like to schedule an appointment with Dr. Natale, contact our friendly staff at Carolina Urology today by calling 786-5131 or by filling out our appointment request form online now. We look forward to serving you.
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The Prostate Cancer Biopsy: Your Ultimate Diagnostic
Depending on the findings of both the DRE and PSA screenings, the final diagnostic step is frequently a biopsy or sampling of the cells inside the prostate. In this procedure, Lepor says, 12 to 14 cores are removed and tested for the presence of cancer cells and their type, size, and aggressiveness .
The method of notating this measurement is called the Gleason score, and it ranges from 2 to 10 .
But as effective as the biopsy can be in determining both risks and treatment choices, Lepor points out that it doesn’t always render clear-cut results.
“It’s entirely possible for the sampling to pull up cells that indicate only a moderate or even incidental cancer when right next door there could be more aggressive cells,” he says.
If the decision is then made to remove the prostate, and no more aggressive cells are found, then the surgery might have been unnecessary. But at the same time, he says, not doing the surgery — and missing the aggressive cells — could mean death.
But rather than blame the PSA for the unnecessary procedures, both Hall and Lepor say it can aid in making the right treatment decision.
“While the PSA does not yield a cancer diagnosis on its own, together with other pieces of information it forms a risk profile, and it is that risk profile that can be very important when determining an individual man’s course of treatment,” says Hall.
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.
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Identifying Potential Prostate Problems
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Indications For Prostate Exam Procedure
It is important to clarify that the prostate exam is not for any man. Medical science has established ages and protocols to determine who benefits from tracking and who does not.
The main parameters have to do with the age of the patient:
- Over 50 years: these men need to do a prostate exam every year or every two years.
- Between 45 and 50 years: This age group get screenings if you have risk factors for prostate cancer. For example, descendants of black races or those who have had a family member with diagnosed prostate cancer.
- Under 40 years: it is rare for a person under forty years to have an indication for prostate examinations. Men with more than one close relative with prostate cancer are candidates.
When the need for the prostate exam is determined, the doctor orders a prostate antigen measurement and a rectal exam. The measurement is carried out with laboratory techniques through a blood sample and digital rectal examination, in the same office.
If the laboratory results are normal, the patient will have to repeat it in one year. In some cases, without risk factors, prostate antigen measurement can be scheduled every two years.
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What To Expect During Your Prostate Exam
If you’ve been avoiding a prostate exam, you could be putting your health at risk. Knowing the facts about the procedure will help put any fears, concerns, or squeamishness to rest.
If you’re a man older than 40 and have not yet had a prostate exam, it’s a good time to talk to your doctor. If you’re also African American or have a family history of prostate cancer, it’s a really good time. One of six men eventually gets a prostate cancer diagnosis. And even though most men have a slow-growing type, prostate cancer is still the leading cause of cancer deaths in men older than 75. So if you’re afraid of a prostate exam, it’s time get over it and protect your prostate health.
“Start talking about your prostate care plan at age 40, and if you and your doctor think the time is right, get a digital rectal exam and a PSA blood test during your annual physical,” suggests Dan Zenka, senior vice president of the Prostate Cancer Foundation and a prostate cancer survivor who was diagnosed at age 51 in 2010.
What to Expect During a Primary Care Prostate Health Exam
Your doctor will probably start by asking you if you have any prostate health symptoms like a weak urine stream, dribbling, straining to urinate, or blood in your sperm or urine. Your doctor may also ask if you have a father or a brother with prostate cancer – and if the doctor doesn’t ask, volunteer the information.
Here are the two tests that will be done:
What to Expect if You Need a Prostate Cancer Exam