The Prostate Exam: What You Should Know
Get the facts on causes, diagnosis, prevention, and much more. The ACS guys there will be aboutnew cases of prostate cancer in the United States in About 26, men will die from it. Medically reviewed by Timothy J. Legg, Ph. Who should get a prostate exam? The most common surgery used to treat an enlarged prostate is called transurethral resection of the exam, or TURP.
Before having a PSA test, tell your doctor about any medications and supplements you take. Chronic bacterial prostatitis causes recurring infections in the prostate. Learn more: Prostate-specific antigen PSA exam ». Your doctor may want to repeat the test. A prostate screening can help your doctor find prostate cancer early. You should tell your doctor if you have hemorrhoids, anal tears, or other problems with your anus.
Some doctors do it as part of a routine checkup. The most common way for doctors to check on the health of your prostate is with a DRE. Your doctor will lubricate a gloved finger and gently place it inside your rectum. What happens next? You may also feel the urge to urinate, especially if your prostate is enlarged or inflamed. The PSA test can result in false-positives and false-negatives for prostate cancer. Chronic prostatitis is inflammation Try the prostate that lasts for at least 3 months.
Prostatitis and benign prostatic hyperplasia BPH are two conditions that affect the prostate. A prostate exam can help your doctor diagnose an enlarged or inflamed prostate.
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.
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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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
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:
- BPH
- 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
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What If I Am Diagnosed With Prostate Cancer
Many people have been where you are standing. Dont lose hope. More than 3.1 million American men have been diagnosed with prostate cancer and are alive today.
The first thing you should consider doing is to find out about the specifics of your cancer. You should know your stage and grade .
From there you can find out what treatment options you want to pursue, if any. Talk to your doctors. Choose a healthcare team of different specialists, or consult a second opinion. You can also do your own research, or talk to men who have been in your position. Many of our advocates are patients and survivors hear their stories at the video library. Or head to the rest of our website to start some research.
Determining who needs treatment for prostate cancer has evolved with new options to diagnose aggressive vs. indolent disease. Check out our infographic with more information on what genomic and advanced tests are available based on a mans individual cancer.
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Who Should Get A Digital Rectal Exam
Not all medical institutions agree on when men should begin screening for prostate cancer or even if a DRE should be part of the screening.
To help detect prostate cancer in its early stages, the American Cancer Society recommends that men talk to their doctors about the benefits, risks, and limitations of prostate cancer screening before deciding whether to be tested.
For most men at average risk, discussions about screening begin at age 50. However, some doctors recommend that men at higher risk of prostate cancer — African-American men or men with a family history of prostate cancer — start screening earlier.
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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.
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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Should You Know Your Psa Level
Instead of a national screening programme, there is an informed choice programme, called prostate cancer risk management, for healthy men aged 50 or over who ask their GP about PSA testing. It aims to give men good information on the pros and cons of a PSA test.
If you’re a man aged 50 or over and decide to have your PSA levels tested after talking to your GP, they can arrange for it to be carried out free on the NHS.
If results show you have a raised level of PSA, your GP may suggest further tests.
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.
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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.
Benefits And Harms Of Screening
The benefit of screening is that the disease is often curable with early detection . Common treatments like surgery or radiation aim to remove or kill all cancerous cells in the prostate. If the cancer spreads beyond the prostate before it is treated, it is often fatal. However, the cancer usually grows so slowly that it is often equally safe to wait until there are symptoms before attempting to diagnose prostate cancer. Symptoms of prostate cancer might include urinary problems, difficulty having an erection, or blood in the urine or semen.
The harms of screening include 1) inaccurate results leading to unnecessary biopsies and complications, and 2) complications from unnecessary treatment. Even if a man has prostate cancer, if he does not have symptoms he may not need to be treated. Experts estimate that between 18% and 85% of prostate cancers detected by these screening tests would never become advanced enough to harm the patient. This wide range of uncertainty, however just adds to the confusion.
Unnecessary treatment costs a lot of money, but the main concern is the complications, which include serious and long-lasting problems, such as urinary incontinence and impotence.15
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When Should I Go Back
The answer to how often you should get a prostate exam depends on your medical history, but if youve got the all-clear, when you return depends on your age. The recommendations are as follows:
Age 50 59:
- If your PSA was between 1 and 3ng/mL: return every 2 to 4 years
- If your PSA was under 1ng/mL: return aged 60
Age 60 70:
Is Drinking A Lot Of Water Good For Your Prostate
If you have BPH or prostatitis, make an effort to reduce your caffeine intake by cutting back on coffee, soda or energy drinks. Avoiding caffeine can make a big difference in your urinary health. Another important drink for you prostate is water. Stay hydrated, and do not try to drink less to reduce your urine.
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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
Prostate Exam Every 4 Years
The current guidelines of the American Cancer Society recommend that men over age 50 should be “offered” a prostate exam every year
The Story: A new European study has shown that a thorough screening for prostate cancer every 4 years is adequate. The screening comprises a PSA blood test, a digital rectal exam, and a transrectal ultrasound. “Very few, if any, aggressive prostate cancers escape screening….”
It looks as if the American Cancer Society guidelines for prostate cancer screening may be changing. Transurethral ultrasound is a procedure used to examine the prostate. An instrument is inserted into the rectum, and sound waves bounce off the prostate. These soundwaves create echoes, which a computer uses to create a picture called a sonogramof the prostate.
Prostate Cancer Screening Interval of 4 Years Misses Few Cancers, StudyShows
Linda Wang, AssistantNews Editor, Katherine Arnold, News Editor, Journal of the National CancerInstitute
A 4-year screening interval was adequate to detect most cancers ina large European randomized trial of prostate cancer screening, accordingto a study in the October 1 issue of the Journal of the NationalCancer Institute.
In the study, men were divided into two groups: an intervention group that received two scheduled screens 4 years apart, and a control group that did not receive scheduled screening. The researchers checked the Dutch national cancer registry annually for cases ofprostate cancer among the study participants.
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Can You Refuse A Prostate Exam
A rectal exam for tone, sensation and volition, plus a check of the bulbocavernosus reflex for completeness sake is the best and quickest way to confirm your suspicions and send him packing. Unfortunately, you cant do the rectal without his consent.
Preparing For A Prostate Exam
Theres nothing special that you need to do to prepare for a prostate exam. Tell your doctor if you have anal fissures or hemorrhoids, as a DRE may aggravate these conditions.
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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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