Specialist Referral And Biopsy
Your doctor will discuss your prostate check results with you. If the PSA and DRC results suggest you have a high risk for prostate cancer, your doctor will refer you to a urologist .
The specialist will discuss having a prostate biopsy, in which a small sample of your prostate gland cells are taken for examination.
The aim of the biopsy is to confirm whether or not you have prostate cancer and, if so, whether it needs treatment. The treatment options will then be discussed with you.
If the biopsy shows no evidence of cancer, you may be advised to attend future check-ups.
What To Expect During The Digital Rectal Exam
Your doctor may examine you either standing or lying down.
- If standing, you will be asked to stand facing the examination bed, with feet apart, body bent forward and your arms or elbows on the bed. Feel free to ask your doctor to give you a heads up before making any sudden movements.
- Wearing surgical gloves, the doctor will coat a finger in lubricant.
- The finger will be inserted into your rectum in a downwards angle. You may feel a little pressure or slight discomfort, but it shouldn’t hurt. It is important to relax and take deep breaths and let the doctor know immediately if there is pain.
- Your doctor may have to wait a few seconds for your external sphincter muscle to relax, and may ask you to bear down as if you are having a bowel movement.
- The doctor moves the finger in a circular motion in order to identify the lobes and groove of the prostate gland. The doctor checks for:Lumps on or around the prostate
- Swelling
- Hard spots or bumps
- Abnormalities on the prostate
- A normal prostate is usually around 2-4 cm long and has a triangular shape, with a firm and rubbery texture
Howard Wolinsky Looks For The Evidence And Doesnt Find Much
Like most men, Ill never forget my first time.
I was 50-ish. On command, I dropped my drawers and bent over the examining table. I heard the snap of the gloves and I felt some resistance as an index finger was inserted in my taut rectum for the dreaded digital rectal exam . I squirmed a little.
Next thing I knew, my family doctor was exploring my until-then-ignored, invisible-to-me prostate gland, looking for unusual bumps and textures. The rest is a blur.
The verdict? Its small but just wait, the doctor told me authoritatively.
As it happens, she was wrong. My prostate never got large. But small doesnt mean I escaped carefree. About seven years later, my prostate-specific antigen scan, not something to which I paid much attention, suddenly rose to nearly 4 ng/mL and a biopsy was performed, the first of several over the years since 2010. I had a near-microscopic cancer in a single core 1 mm long, with a low-risk Gleason 6. Seen once, never seen again.
I go to the urologist twice a year. We chat about PSA results and then its time for another DRE. I once wrote a story about researchers working with female primates who were trained to present for gynecologic tests. I feel something like that undergoing my biennial DREs.
DREs were a key to diagnosing prostate cancer maybe back 30, 40 years ago before the era of PSAs and magnetic resonance exams.
Most doctors take the attitude of why not perform the DRE? It wont hurt and might help.
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Average Psa Test Doubling Time
Another red flag. This calculation denotes the time it takes your PSA values to double.
Therefore it may signify the aggressiveness of any prostate abnormalities, whether it’s an enlarged prostate, prostatitis, or prostate cancer.
If your average PSA readings double in less than three years your doctor will most likely order a biopsy, to look in to the problem further and discuss possible prostate cancer treatment options.
What Is The Prostate
The prostate is a small gland in the pelvis, found only in men.
About the size of a satsuma, it’s located between the penis and the bladder, and surrounds the urethra.
The main function of the prostate is to produce a thick white fluid that creates semen when mixed with the sperm produced by the testicles.
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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.
How Is The Test Performed
To perform a DRE, your doctor will gently insert a gloved, lubricated finger into your anus. This allows them to feel for any abnormalities. For example, an enlarged prostate feels like a bulge behind the rectum wall. Prostate cancer may feel like bumps on the normally smooth surface of the prostate.
Read more: What do you want to know about prostate cancer? »
Men may feel pain or the urge to urinate during the exam. This is because your doctor is applying firm pressure to the prostate.
A DRE is typically done as part of a routine physical examination for both men and women. During a gynecological exam, your doctor may perform a DRE to check the space between the rectum and the vagina for any abnormalities. Most men and women feel only minor discomfort during the procedure. People with hemorrhoids or anal fissures may experience a small amount of bleeding.
A DRE isnt suitable for detecting colon cancer. Only a small portion of the lower colon may be accessed during a DRE. However, a DRE may be used to obtain a stool sample. If blood is present in the stool, it may indicate colon cancer or other problems.
Blood isnt always visible to the naked eye in a stool sample, so your doctor may wish to conduct a fecal occult blood test to confirm.
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Symptoms And Characteristics Of Prostatitis
From the clinical symptoms it can be seen that the main symptoms of prostatitis are shown at somewhere else. That is, many symptoms are outside the lesion. So for the initial patients who are suffering from the disease, it is most likely to delay the disease and the best timing of treatment. We can conclude them into the following three categories:
1, Symptoms of prostate pain
The pain mainly appears at the back, perineum, lower abdomen, bilateral inguinal area, testes, anus, etc. A slight pain and a feeling of bulge discomfort. In the clinical we found that some young patients, due to abdominal pain which we should get into deeply investigation, but in the end doctors treat it as gastroenteritis. This will ultimately be invalid and even delay the treatment of the disease.
2, Urinary tract symptoms
The symptoms mainly show as dysuria, such as hard voiding, prolonged voiding, unclean urination, thinner urine, urine interruption, or even a bit like droplets or urination dysfunction. Some of these patients were found to have mild bladder irritation symptoms. And they have received treatment according to urinary tract infection with long-term ineffectively. What is more, it will also delay the best time for treatment.
3, Sexual dysfunction symptoms
What Should I Look Out For
The above recommendations apply to screening only i.e. if youre not experiencing symptoms. For many men, prostate cancer can be symptomless because of the way it grows: youll only notice changes if it grows too close to your urethra, disrupting the urinary process. The symptoms of this include:
- Trouble starting a urine stream
- Having a weak urine stream
- Dribbling at the end of urination
- Urinary retention
- Pain after urination or ejaculation.
If youre experiencing these, you should come in for a prostate exam. However, dont panic: the most common cause of the above isnt cancer its benign prostatic hyperplasia . This is when your prostate naturally grows large enough to block your urinary tract. 50% of men aged 51 60 suffer from it, and the number rises as you age. There are a number of treatment options available, from lifestyle changes and medications to minimally invasive procedures and surgery.
Another cause of these symptoms could be prostatitis, which is when your prostate becomes infected. This usually affects men aged 30 50. Additional symptoms include pain in and around your penis, testes, anus, abdomen or lower back, or erectile dysfunction. Usually, this will improve over time and with treatment.
The other symptoms to look out for are signs that prostate cancer has spread. If the cancer breaks out of the prostate, symptoms could include back, hip or pelvis pain, erectile dysfunction, blood in urine or semen, and unexplained weight loss.
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Preparing For Prostate Examinations
Due to the personal nature of a prostate examination, its normal to feel a bit anxious but it will be easier if you relax and practise some deep breathing.
You should tell your doctor if you have any conditions that might be made worse by a DRE, such as haemorrhoids or an anal fissure. You should also tell them about any medications you are taking.
Recent ejaculation can affect your PSA level, so your doctor might ask you to abstain from sexual activity for a period of time before your examination.
If Youre The Receiving Partner
Youll want to be as relaxed and aroused as possible, because itll make the experience easier and more enjoyable.
The whole poop-comes-out-of-the-butt thing gives some people a case of the heebie-jeebies even when its their own butt.
Remedy this by taking a shower and paying a little extra attention back there to get it squeaky clean. Some people like to use an enema before engaging in butt play, but it isnt necessary.
Use the bathroom before getting started. Prostate stimulation can make you feel like you need to pee, and anal penetration can cause the sensation of needing to poop.
Even though you wont actually do either, worrying that you might can interfere with your ability to let go and enjoy yourself. Knowing your bladder and bowels are empty can help.
Getting used to the sensation of having your prostate touched can help, too. Practice with an anal sex toy, like a butt plug, or your fingers.
Be sure to set the mood so that youre turned on and primed for action. Light candles, watch porn, or engage in some good old-fashioned masturbation or foreplay to get there.
Finally, be sure to lube up real good. Applying a water-based lubricant will allow for easier penetration and make for some easy gliding if stimulating your prostate externally.
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How Is Prostate Cancer Diagnosed
Prostate cancer can be diagnosed by following tests, remembering they ought to support the context of the patients signs and symptoms.
Additionally, your doctor may conduct a biomarker test. Biomarkers, found in the blood or urine are substances produced by a cancerous tumour or antibodies produced by the body to combat the tumour. Almost all diagnoses of prostate cancer will require a biopsy at some point.
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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What Not To Do Before A Psa Test
Chemotherapy Alternatives, Men, Prostate, Testosterone
The prostate-specific antigen test, which is used to assess your risk for prostate cancer, can be stressful for some men.
The results of the test can indicate whether you might need to undergo further testing for prostate cancer. While the PSA test is not a perfect test, it is still considered one of the important tests for men over 50, along with a digital rectal examination of the prostate .
You may wonder, What is PSA and should I get a PSA test? While the experts have different recommendations for the PSA test, they all agree that the PSA test is one important tool you can use to monitor your prostate health. You should get the PSA and DRE regularly, especially if you have a family history of prostate cancer.
That being said, there are few activities that can artificially and temporarily increase your PSA level. It is important to know what not to do before a PSA test so that your results will be as accurate as possible and do not cause you to stress over falsely high numbers. In the 48 hours before your PSA test you should NOT:
- Ride a bike, motorcycle or tractor or anything that puts pressure on the prostate region.
- Participate in vigorous exercise that could jostle the prostate area .
- Have a DRE. Schedule your DRE for after you have the PSA test.
- Ejaculate or participate in any sexual activity that involves ejaculation.
What If We Find Something
A rectal exam can give us an indication that cancer may be present but discovering a lump is not a cancer diagnosis. If the examiner finds the surface of your prostate to be hard and lumpy or your PSA levels are higher than expected you may be referred for additional tests. If you havent already seen a Consultant Urologist they may conduct another rectal exam to check the GPs initial assessment.
The next step is usually to have an MRI scan so an image of your prostate can be examined. If necessary, you may then be referred for a biopsy to take a sample from your prostate. Even then, finding cancer cells in your prostate doesnt necessarily mean youll need cancer treatment. Find out more on the truth about prostate cancer diagnosis here.
*Reference: NHS England
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Is Surgery Effective For Men With Early
When they hear the word cancer, many men want it treated immediately no matter how slow it is growing or how unlikely it is to be fatal. The question is: if found in its early stages, should prostate cancer be treated?
In July 2012, a study by researchers at the Department of Veterans Affairs was published in the New England Journal of Medicine, examining the effectiveness of surgery in men with early-stage prostate cancer.16 Known as the Prostate Cancer Intervention versus Observation Trial, or PIVOT, the study compared surgical removal of the prostate with no prostate cancer treatment. The 731 men who participated in the study, with an average age of 67, were randomly assigned to one of the two groups and followed for 8 to 15 years. All the men were enrolled between 1994 and 2002, with a final check-up taking place in 2010. Men in both groups went to the doctor every six months during the study, and men in the observation-only group were offered palliative therapy or chemotherapy to relieve symptoms due to the cancer spreading to other parts of the body. Neither therapy can eliminate the cancer and, therefore, are not treatments.
Since prostate cancer treatment can cause serious side effects such as erectile dysfunction and incontinence, active monitoring seems to be a reasonable option.
All articles are reviewed and approved by Dr. Diana Zuckerman and other senior staff.
References
How To Check Your Prostate
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.
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