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
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
How A Doctor Performs A Prostate Exam
The male reproductive system relies on a healthy prostate to function. The prostate is a relatively small gland. It is the size of a chestnut . The prostate produces a fluid that combines with sperm.
The prostate fluid helps to nourish sperm. In turn, reproduction is possible, and semen can survive in the acidic environment of the vagina.
There are times when a prostate may give a man problems. Several complications have been linked to the prostate gland. Benign prostatic hyperplasia is generally considered the most common type of prostate condition.
Other common issues that men are concerned about include prostate cancer and prostatitis.
Prostate screening is one of the first diagnostic tools used to detect these problems.
While men generally find this to be an uncomfortable procedure, its benefits need to be considered.
We take a look at how a prostate exam is done. The post also considers why a prostate exam is done.
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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.
How Is Prostate Cancer Treated
For many men with prostate cancer, treatment is not immediately necessary.
If the cancer is at an early stage and not causing symptoms, your doctor may suggest either “watchful waiting” or “active surveillance”.
The best option depends on your age and overall health. Both options involve carefully monitoring your condition.
Some cases of prostate cancer can be cured if treated in the early stages.
- radiotherapy either on its own or alongside hormone therapy
Some cases are only diagnosed at a later stage, when the cancer has spread.
If the cancer spreads to other parts of the body and cannot be cured, treatment is focused on prolonging life and relieving symptoms.
All treatment options carry the risk of significant side effects, including erectile dysfunction and urinary symptoms, such as needing to use the toilet more urgently or more often.
For this reason, some men choose to delay treatment until there’s a risk the cancer might spread.
Newer treatments, such as high-intensity focused ultrasound and cryotherapy, aim to reduce these side effects.
Some hospitals may offer them as an alternative to surgery, radiotherapy or hormone therapy.
But the long-term effectiveness of these treatments is not known yet.
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When To Get A Prostate Exam
For many years, all patients were recommended to get a prostate exam after a certain age.
Right now, the recommendations by the U.S. Preventive Services Task Force are slightly different. Prostate cancer screening should start after 55 years, but not all patients should get screened .
If you dont have risk factors or symptoms, your age is not enough reason to screen.
Still, you can do it if youre worried about your prostate.
Also, keep in mind that some average risk factors could be unknown to you. Thus, the best way to know if you need a prostate exam or not is by asking your urologist.
Men should decide for themselves if they prefer to perform an exam.
Still, health authorities recommend that males with a healthy prostate after 70 years do not perform additional exams .
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 Ã¢ 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.
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Types Of Prostate Cancer Screening: Psa Blood Tests And Digital Rectal Exams
Prostate cancer occurs when cells create small tumors in the prostate gland, which is an important part of the male reproductive system. Screening can be performed quickly and easily in a physicians office using two tests: the prostate-specific-antigen blood test, and the digital rectal exam , a manual exam of the prostate area.
Most screening tests are not 100% accurate, but these prostate tests are especially inaccurate. Most men with a high PSA level do not have prostate cancer , and some men with prostate cancer have a low PSA level . The DRE also results in many false positives and false negatives. Using both screening methods together will miss fewer cancers but also increases the number of false positives, which can lead to more testing and possibly result in medical complications. A biopsy to determine if there is a cancerous growth in the prostate involves inserting a needle, usually through the rectum, to remove a small sample of prostate tissue.
What If My Test Results Are Abnormal
If the results of early detection tests like the PSA screening or the digital rectal exam suggest that you might have prostate cancer, your doctor will conduct further testing. The PSA may be repeated, or you may be sent to a specialist for more tests such as a transrectal ultrasound and a prostate biopsy.
In a prostate biopsy, a tissue sample is taken from your prostate. Cancer can only be diagnosed with a tissue sample.
Recent research has yielded additional tests that in addition to the PSA and subsequent DRE and Biopsy that can give a doctor more information on to determine the probability of both finding cancer during a biopsy and determining how aggressive that cancer is likely to be. Read more on those tests.
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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.
âThere are specific patient level factors that have to go into that decision, including family history, comorbidities, and life expectancy,â said Ehdaie, who said that people who are not expected to live more than another decade may not be advised to get screened. âAnd of course, the patientâs own preferences are taken into account, their goals, what they want to achieve.â
How Do I Get Tested
A general practitioner or an urologist can perform a full prostate cancer exam. This would usually include a PSA blood test and digital rectal exam, also called a DRE.
A Prostate Specific Antigen screening measures the level of PSA in the blood. PSA is a substance made by the prostate. The levels of PSA in the blood can be higher in men who have prostate cancer. The PSA level may also be elevated in other conditions.
A Digital Rectal Exam is a test that is done when 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.
Talk to your general doctor or urologist about receiving a prostate exam. If you do not have a doctor, do not have insurance, and cannot afford a test, find out what free screenings are available in your area on our Free Testing Map. If you do not see a free screening in your area, check back in the fall. Many screenings occur in September, during Prostate Cancer Awareness Month.
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Risks And Benefits Of Prostate Cancer Screening
There are two main benefits of prostate cancer screening.
One is potentially preventing death from prostate cancer. Many men have prostate cancer without experiencing symptoms, so screening can potentially identify prostate cancer early on when it can be treated more easily.
Another benefit of screening and early detection is potentially catching prostate cancer in its early stages, allowing for more effective treatment. Earlier treatment can help prevent prostate cancer from spreading beyond the prostate , which can cause several symptoms.
Unfortunately, there are drawbacks to prostate cancer screening. The DRE is not very sensitive or specific. This means that people who have prostate cancer can still have a normal DRE, while patients with an abnormal DRE may not have prostate cancer. For these reasons, healthcare providers are no longer performing DRE alone for routine prostate cancer screening and relying instead on the PSA test .
PSA testing also has limitations in screening for prostate cancer. Elevated PSA levels do not only occur in prostate cancer. Prostatitis or an enlarged prostate can also cause PSA levels outside the normal range. Abnormal test results can ultimately lead to undue anxiety and further testing that may prove unnecessary .
Another problem with the PSA test is the potential for overdiagnosis and overtreatment. Screening uncovers patients with prostate cancer who would otherwise never have had any issues resulting from the disease.
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.
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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.”
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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 you’re 55 and have you have a PSA of less than one, you can wait four years to get screened again,” Rettig explained. “Alternatively, if you’re 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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How Often Do I Need To Get A Prostate Exam
A prostate exam is a common examination that is used to check on the current condition of the prostate. As men age, the need to monitor prostate health becomes more of a necessity. Unfortunately, many men neglect the task of having periodic examinations of the prostate. Often, this is due to a misunderstanding about the mechanics of the exam, as well as a lack of information about prostate cancer and what the disease can do if left unchecked.
Prostate exams do not require much, other than a visit to the family physician or urologist. The exam takes place in the doctors office, and involves nothing more than a lubricant and a rubber glove. The physician dons the glove, lubricates the index finger, and inserts the finger into the anus. The prostate can be easily examined through the thin walls of the rectum, allowing the physician to check for growths, texture, and any other abnormalities. Generally, the examination takes only a moment or two and is relatively painless.
Symptoms Of Prostate Cancer
Symptoms of prostate cancer do not usually appear until the prostate is large enough to affect the tube that carries urine from the bladder out of the penis .
When this happens, you may notice things like:
- an increased need to pee
- straining while you pee
- a feeling that your bladder has not fully emptied
These symptoms should not be ignored, but they do not mean you have prostate cancer.
It’s more likely they’re caused by something else, such as prostate enlargement.
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Results And Follow Up
After a DRE, your healthcare provider will know right away if there are any problems like lumps or a prostate that is larger than usual . You will discuss any findings with your provider and plan the next steps. The results from a PSA test typically take around two weeks to come back, and your healthcare provider will go over these with you.
If all of your test results are normal, and you and your provider decide to continue screening, you will most likely need testing every two years. However, if the PSA test is abnormal, your healthcare provider may refer you to a urologist for additional testing.
What Is A Psa Test
If the doctor finds abnormalities during the DRE, then the patient needs to undergo more tests. A PSA test is very commonly requested. It is also called a prostate-specific antigen test, or a PSA blood test.
A PSA test measures the level of prostate-specific antigen in the patients bloodstream. This is an indicator of various prostate-related conditions. The doctor may use the results from a PSA test to determine the abnormality of the male patients prostate.
Several conditions may be detected through a PSA test. This is because the level of PSA in the body increases when certain things affect the prostate gland.
When the prostate is affected by inflammation, the PSA levels will generally increase. The same happens when the man develops an infection in their prostate.
An enlargement of the prostate gland is also known to elevate the protein levels in the mans body. This is an indication of benign prostatic hyperplasia, a prevalent condition in men. When left untreated, an enlarged prostate can cause problems. This includes a risk of infections bladder infection and urinary tract infections can occur.
A PSA test can also help in the diagnosis of prostate cancer. When cancerous cells develop in the prostate gland, the PSA levels in the mans body will also rise.
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