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.
American Cancer Society Recommendations For Prostate Cancer Early Detection
The American Cancer Society recommends that men have a chance to make an informed decision with their health care provider about whether to be screened for prostate cancer. The decision should be made after getting information about the uncertainties, risks, and potential benefits of prostate cancer screening. Men should not be screened unless they have received this information. The discussion about screening should take place at:
- 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 .
After this discussion, men who want to be screened should get the prostate-specific antigen blood test. The digital rectal exam may also be done as a part of screening.
If, after this discussion, a man is unable to decide if testing is right for him, the screening decision can be made by the health care provider, who should take into account the mans general health preferences and values.
If no prostate cancer is found as a result of screening, the time between future screenings depends on the results of the PSA blood test:
- Men who choose to be tested who have a PSA of less than 2.5 ng/mL may only need to be retested every 2 years.
- Screening should be done yearly for men whose PSA level is 2.5 ng/mL or higher.
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.
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When Do You Need A Prostate Exam
PSA is continuously present in the bloodstream for most men, and an increase in its number may be attributed to causes other than cancer. However, men who have an increased risk of prostate cancer should undergo a regular prostate exam.
Age, family history, and race are all possible factors that can increase your risk. Likewise, your doctor may also recommend that you undergo testing if you are experiencing discomfort or pain while urinating.
Symptoms which may indicate that you have a prostate issue include the following:
- Inconsistent flow of urine
How Often Is a Prostate Exam Necessary?
Your frequency of testing may be due to several factors, including your age and present health condition:
How Should You Prepare For A Prostate Exam
You dont need to do any sort of preparation for a prostate exam. You dont need to fast or drink any special liquids ahead of time. You will want to let your doctor know ahead of time if you have hemorrhoids, anal fissures, or other issues that could potentially become aggravated with the procedure3.
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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 hasnt recommended rectal exams because there has yet to be a randomized trial in which some men get the rectal exam and some dont. 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. Its part of the evaluation that we use even if its 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 hasnt been studied, Dr. Freedland adds. Most people are screened with PSA and DRE.
Touching Your Prostate With Your Finger
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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.
Cant I Just Get A Blood Test
If you have concerns about prostate cancer you certainly should have a Prostate Specific Antigen blood test. Knowing your PSA level can help to establish whats normal for you so that a spike is more easily identified. But a blood test alone is not enough. The test has been known to deliver false-positive results in some cases leading men into have invasive biopsies for no reason. Up to 20% of men with prostate cancer show no increase in PSA levels*. So its best used to check against the result of a rectal exam but cant be relied upon in isolation.
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Your First Prostate Exam
The prostate is a walnut-sized gland in men that produces fluid that is a component of semen. The gland has two or more lobesor sectionsenclosed by an outer layer of tissue. Located in front of the rectum and just below the bladder, where urine is stored, the prostate surrounds the urethra, which is the canal through which urine passes out of the body.
The most common prostate problem in men under 50 is inflammation or infection, which is called prostatitis. Prostate enlargement is another common problem. Since the prostate normally continues to grow as a man matures, prostate enlargement, also called benign prostatic hyperplasia or BPH, is the most common prostate problem for men over 50. Older men are at risk for prostate cancer as well, but it is much less common than BPH.
Sometimes, different prostate problems have similar symptoms. For example, one man with prostatitis and another with BPH may both have a frequent, urgent need to urinate. Other men with BPH may have different symptoms. For example, one man may have trouble beginning a stream of urine, while another may have to get up to go to the bathroom frequently at night. A man in the early stages of prostate cancer may have no symptoms at all. This confusing array of symptoms makes a thorough medical examination and testing very important. Diagnosing the problem may require a series of tests.
Male urinary tract, front and side views
Other typical questions are as follows:
Digital rectal exam
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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Is It Time You Booked A Prostate Exam
Prostate checks are a part of life for most adult men. Its a necessary step to ensure that you stay on top of your health and become aware of any abnormalities before they evolve into serious problems.
For many men, it can be a nervous time. General Practitioner, Dr Sir-Kit Leong, from SmartClinics Clayfield in Brisbane has answered some of the most frequently asked questions by patients. Take a read and if youre still unsure, book an appointment with your GP for a chat before committing.
Early Cancer Detection Can Save Lives And Cut Treatment Costs But When Should You Start Having Prostate Exams And Do You Need To Have Them At All
When it comes to screening for prostate cancer, some men may be confused or apprehensive about beginning to get annual exams.
As prostate cancer affects one out of every six men, the American Cancer Society and other leading medical organizations recommend older men discuss having annual prostate cancer screenings with their primary care doctor to help detect the disease early. Early detection of the disease helps cure it in 90 percent of cases.
Generally, it is recommended that men with an average risk of prostate cancer start being screened with a digital rectal exam and PSA blood-level exam when they hit the age of 50. African-American men and men who have a father, brother or son who were diagnosed with prostate cancer when they were younger than 65 are at higher risk and should start screenings at age 40. Men who have had more than one of these close relatives diagnosed before age 65 are at even higher risk.
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When Should You Have Your First Prostate Exam
· Age 40 for men at even higher risk . You should also speak with
When Should You Have Your First Prostate Exam
· 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
Checking For Psa At Home
Itâs best to look for prostate symptoms and then screen using a Prostate Specific Antigen blood test. While there is no physical way for you to check for prostate cancer at home, there are at-home screening options for PSA. imawareâ¢ at-home test for PSA can help screen you for prostate issues.
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How Often Do I Need A Prostate Exam
Prostate cancer is one of the most common types of cancer in men, and its also highly treatable if caught early. There are a number of treatment options that have proven to be successful in combatting prostate cancer, even in its advanced stage.
Early detection is crucial because it gives you more treatment options and a better chance of eliminating cancer. The prostate-specific antigen test is used to check the PSA levels in your blood, and these levels are different for every man the indicator is whether the number is going up as compared to your prior PSA exam result. If your PSA is high the first time you have the test, your doctor may ask you to have a biopsy.
Similarly, your doctor will perform a digital rectal exam during your annual checkup to feel for any lumps or enlargement of your prostate. Lets talk about how often you might need to have a prostate exam and what you can expect.
The Test Is Often Not Needed
Most men with high PSAs dont have prostate cancer. Their high PSAs might be due to:
- An enlarged prostate gland.
- Recent sexual activity.
- A recent, long bike ride.
Up to 25% of men with high PSAs may have prostate cancer, depending on age and PSA level. But most of these cancers do not cause problems. It is common for older men to have some cancer cells in their prostate glands. These cancers are usually slow to grow. They are not likely to spread beyond the prostate. They usually dont cause symptoms, or death.
Studies show that routine PSA tests of 1,000 men ages 55 to 69 prevent one prostate cancer death. But the PSA also has risks.
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How Do Men Feel About The Rectal Exam
I think most men are willing to do it, but some men are exceptionally opposed to it. They might be happy to hear that there are studies ongoing in the United Kingdom looking at using magnetic resonance imaging as a screening tool to be able to avoid doing a digital rectal exam in the future. There is a large African immigrant population in London with a higher incidence of prostate cancerthey didnt want to have the prostate exam because they had a lot of opposition to it. They were uncomfortable with it.
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
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