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How Do They Test The Prostate

What Is A Prostate Ultrasound Used For

How to Test for Prostate Cancer | Ask a Prostate Expert, Mark Scholz, MD

A prostate ultrasound is used to check your prostate gland using ultrasound imagery. The procedure provides your doctor with black-and-white images of your prostate and the surrounding tissues. Your doctor usually wont do this as part of a physical examination, but they may recommend it if:

A prostate ultrasound can also be used to help your doctor take a tissue sample, or biopsy, from your prostate.

Transrectal Ultrasound Scan Guided Biopsy

Your doctor takes a series of small tissue samples from the prostate to examine under a microscope. You have the biopsy through the back passage using a transrectal ultrasound scanner.

A TRUS guided biopsy can be uncomfortable. You usually have a local anaesthetic to numb the area and reduce any pain.

How Often Do I Need A Prostate Exam

There are different factors that will determine how often you need to have a prostate exam and prostate cancer screening.

While PSA levels are one factor, they vary by age. Other factors like your family history, overall health, diet, and lifestyle, also play into how often you should have your prostate checked.

Your provider will take all of these factors into account when they are recommending the timing and frequency of your future prostate cancer screenings.

If you’re not due for a prostate cancer exam yet but notice changes in your health or are having symptoms that you think might be related to your prostate, don’t wait. You can always ask your provider for a checkup sooner.

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Two Main Screening Tests

There are two tests commonly used to screen for prostate cancer:

  • The Digital Rectal Exam : 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.
  • The Prostate Specific Antigen Test: This exam measures the level of PSA in the blood. The levels of PSA in the blood are often higher in men who have prostate cancer. The PSA level may also be high in other conditions that affect the prostate.Usually, the higher the bloods PSA level is, the more likely it is that a prostate problem is present. But other factors, such as age and race, also can raise PSA levels. PSA levels also can be impacted by certain medical procedures, some medications, an enlarged prostate or a prostate infection.Since your PSA level may be high for other reasons, your doctor will need to interpret the test results.

If the results of the PSA and/or DRE suggest that you might have prostate cancer, your doctor will need to do a prostate biopsy to find out. This means a sample of your prostate tissue will be removed with a needle and sent to a lab, where a specialist will determine if it contains cancer cells.

Should I Have A Psa Test

Prostate Cancer Tests: How Effective Are They?

If you have no symptoms of prostate cancer and are thinking about having a PSA test, you should ask your doctor about the risks and benefits.

While some studies suggest PSA reduces mortality on a population basis, the test picks up large numbers of cancers that would have caused no symptoms or harm in the patient. This is known as overdiagnosis. Overdiagnosis of prostate cancer can lead to unnecessary treatments that have side effects such as sexual impotence, urinary incontinence and bowel problems.

It is important to balance the potential benefit of detecting a prostate cancer early against the risk that detection and treatment may not be necessary. Treatment may affect your lifestyle but it may also save your life.

Make your own decision about whether to be tested after a discussion with your doctor. Ensure you get good quality information to make an informed decision.

Screening tests for breast, bowel and cervical cancer can save lives, but there is still confusion around PSA testing for prostate cancer. Find more information here.

Remember, if you have any concerns or questions, please contact your doctor.

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What Should I Expect During A Prostate Exam

As mentioned above, there are two types of screenings that your healthcare provider may use to detect prostate cancer: a PSA blood test and a digital rectal exam . Research shows that the PSA blood test is more effective for detecting prostate cancer. However, the DRE can still find cancer in people with normal PSA levels. For this reason, many healthcare providers recommend both.

Neither test confirms you have prostate cancer, which is why theyre considered screening assessments rather than diagnostic tests.

PSA blood test

For this test, your healthcare provider simply draws a sample of your blood and sends it to a lab for analysis. The PSA blood test measures the amount of prostate-specific antigen in your blood.

There is no official cutoff score that can determine whether or not you have prostate cancer. Instead, the results are used as a gauge to determine if more testing is needed.

If you have a high PSA, you may need further testing such as a prostate biopsy, MRI or other lab tests to determine if prostate cancer may be present.

Digital rectal exam

During a DRE, your healthcare provider inserts a lubricated, gloved finger into your rectum. This way, they can feel your prostate to see if there are any lumps or bumps on the back portion of the gland .

Genetic Testing For Prostate Cancer

You may hear a lot about genetics or genomics. Both terms are related to genes and cell DNA, but they are different. These tests are being used to learn more about the DNA of cancer cells, and link DNA mutations with treatments. In the future, genetic testing may be the first step doctors take when diagnosing prostate cancer.

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Psa Screening Blood Test

The American Cancer Society reports that men with a total PSA level of between 4 and 10 have roughly a 1 in 4 chance of having prostate cancer. With a total PSA of over 10, the chance of having prostate cancer rises to over 50%. Following the PSA test, if the levels are high, a doctor may suggest a repeat screening test or a prostate biopsy.

In addition to prostate cancer, there are many other factors that can affect a mans PSA levels.

Reasons for a High PSA:

Reasons for a Low PSA:

Psa Test: The Current Prostate Screening Standard

What it’s like to go for a rectal screening for prostate cancer

Before recommending when you should be screened for prostate cancer, yourdoctor will consider many factors, such as:

  • Family history, particularly whether any of your family members have had prostate cancer
  • Race, as African-American men have a higher risk of developing prostate cancer

If your doctor determines you should undergo screening, he or she will mostlikely recommend the PSA test. For more than 30 years, the PSA test hasbeen the gold standard in prostate cancer screening. This simple blood testmeasures how much prostate-specific antigen is in your blood.

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Do All Men Who Are Treated For Prostate Cancer Lose Sexual And Urinary Function

Its definitely not true that all men are incontinent and impotent after treatment for prostate cancer. Urinary incontinence is usually temporary.

There can be a sexual impact for guys who have normal function. If the cancer is near their nerve bundle, theyre going to have a decrease in sexual function. If its not, and we can do bilateral nerve sparing surgery, studies show 70 percent can get back their normal sexual function. It all depends on where the cancer is. But the truth is that we cant predict very well who will be the 30 percent who will haveor still haveED some already do have ED because of age, diabetes, hypertension or renal failure.

How Is Prostate Cancer Detected

There is no single test to detect prostate cancer. The two most common tests are the prostate specific antigen blood test and the digital rectal examination .

The PSA test measures the level of PSA in your blood. It does not specifically test for cancer. Virtually all PSA is produced by the prostate gland. The normal range depends on your age. A PSA above the typical range may indicate the possibility of prostate cancer. However, two-thirds of cases of elevated PSA are due to noncancerous conditions such as prostatitis and BPH.

A DRE is generally conducted by a urologist to feel the prostate. While DRE is no longer recommended as a routine test for men who do not have symptoms of prostate cancer, it may be used to check for any changes in the prostate before doing a biopsy.

If either of these tests suggest an abnormality, other tests are necessary to confirm a diagnosis of prostate cancer, usually a magnetic resonance imaging scan and transrectal ultrasound biopsy.

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What Happens After A Prostate Ultrasound

Once the test is done, you can take off the gown and put your clothes back on. Your rectum may feel tender for a few days, but you wont need to follow any specific aftercare instructions. Your doctor may prescribe an antibiotic to prevent infection.

In some cases, your doctor or technician may ask you to wait in the facility until your results are available. Youll usually need to wait a few days for a radiologist to look at the images and diagnose any conditions, however. Depending on where the test was done, you may wait up to two weeks for results.

Your doctor will schedule a follow-up appointment to discuss your test results. If you have any abnormalities or conditions that are visible on the images, your doctor will point out these areas. Excess tissue, prostate enlargement, or cancerous tumors will appear on the ultrasound images as bright white areas that represent the dense tissue.

Do You Really Need A Prostate Exam

New study shows why men should get a PSA test for prostate cancer ...

Prostate cancer is the second-leading cause of cancer death in American men, behind only lung cancer. , a urologist at Lawrence + Memorial Hospital and an associate professor of Urology at Yale School of Medicine, sees patients with urologic cancers in collaboration with the Smilow Cancer Hospital Care Center in Waterford and the Prostate and Urologic Cancers Program at Smilow Cancer Hospital. Here he offers advice about the importance of rectal exams, PSA blood tests and screenings for prostate cancer.

Good health should be a year-round concern for men not just in November. This time of the year should be a time for men to reflect on things in their life that they can change to impact their overall health for the better.

Talk to your doctor. If you dont have one, call 833-346-3637 or visit Find a Doctor for a referral to a primary care physician near you.

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What Is The Chance Of A Diagnosis Of Prostate Cancer

Around 17,000 new cases of prostate cancer are diagnosed each year in Australia. It affects mostly men in older age groups and is rare in men under 50 years of age.

The chance of developing prostate cancer is significantly higher in men who have a close relative with prostate cancer the risks are higher if the relative was diagnosed before the age of 60.

If you have a family history of prostate cancer, talk to your doctor.

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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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.

Who Should Get A Prostate Exam

Avoid prostate biopsies with new cancer screening

Starting at age 50, all men should discuss prostate cancer screening with their doctor. The American Cancer Society advises men at higher risk to have this conversation at age 45.

Youre considered to have an increased risk if youre African-American or if a first-degree relative had prostate cancer before age 65. If more than one first-degree relative had prostate cancer before age 65, you might want to consider beginning prostate cancer screening even earlier.

The ACS estimates there will be about 26,120 men will die from it.

Prostate cancer is easier to treat before it spreads. However, some prostate cancers are so slow-growing that they dont always require treatment. A lot depends on your age and other factors.

Discuss your risk factors with your doctor, and ask if you should have a prostate exam as part of your yearly checkup.

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How Soon Will Prostate Test Results Be Available

Results for simple medical tests such as some urodynamic tests, cystoscopy, and abdominal ultrasound are often available soon after the test. The results of other medical tests such as PSA blood test and prostate tissue biopsy may take several days to come back. A health care provider will talk with the patient about the results and possible treatments for the problem.

Use In Men Who Might Have Prostate Cancer

The PSA blood test is used mainly to screen for prostate cancer in men without symptoms. Its also one of the first tests done in men who have symptoms that might be caused by prostate cancer.

PSA in the blood is measured in units called nanograms per milliliter . The chance of having prostate cancer goes up as the PSA level goes up, but there is no set cutoff point that can tell for sure if a man does or doesnt have prostate cancer. Many doctors use a PSA cutoff point of 4 ng/mL or higher when deciding if a man might need further testing, while others might recommend it starting at a lower level, such as 2.5 or 3.

  • Most men without prostate cancer have PSA levels under 4 ng/mL of blood. Still, a level below 4 is not a guarantee that a man doesnt have cancer.
  • Men with a PSA level between 4 and 10 have about a 1 in 4 chance of having prostate cancer.
  • If the PSA is more than 10, the chance of having prostate cancer is over 50%.

If your PSA level is high, you might need further tests to look for prostate cancer.

To learn more about how the PSA test is used to look for cancer, including factors that can affect PSA levels, special types of PSA tests, and what the next steps might be if you have an abnormal PSA level, see Screening Tests for Prostate Cancer.

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When Should I Have A Prostate Check

Generally, if you aged 50 years or older and have any urinary symptoms, you should let your doctor know. They will discuss with you whether or not you should have a prostate check.

Symptoms include:

  • dribbling after you are done peeing
  • needing to pee more often, at night or urgently
  • trouble starting peeing

If you have no symptoms, it is recommended that you get checked if you:

  • you are a man aged 5070 years old but dont have any family history
  • you are a man aged 4070 years old and your father or brother has had prostate cancer
  • you are a man aged more than 70 years old and you have family history of prostate cancer or you have had an abnormal PSA test previously, and you have a life expectancy of more than 10 years.

Having a prostate check is your decision. The tests for prostate cancer can be uncomfortable but they may reduce your chance of being harmed or dying from prostate cancer.

If your test results suggest you are at risk of cancer, you will need to decide whether to have further testing and possibly treatment. In making this decision, you will need to consider whether your quality of life will be better living with a slow growing cancer than having treatments, which may cause you more harm than the cancer ever will.

Your doctor can help you weigh up the benefits and risks of being tested, by taking into consideration factors such as your age and family history.

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Genetic Testing For Some Men With Prostate Cancer

Morningside Medical Practice

Some doctors now recommend that some men with prostate cancer be tested to look for certain inherited gene changes. This includes men in whom a family cancer syndrome is suspected, as well as men with prostate cancer that has certain high-risk features or that has spread to other parts of the body. Talk to your doctor about the possible pros, cons, and limitations of such testing.

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What Are The Prostate Cancer Symptoms I Need To Look Out For

In its early stages, prostate cancer may not show any symptoms. Symptoms of early prostate cancer can include:

  • difficulty passing urine
  • a slow, interrupted flow of urine
  • frequent passing of urine, including at night

Symptoms associated with advanced prostate cancer include:

  • pain during urination
  • lower back or pelvic pain.

These symptoms are also found in men who may have benign prostatic hyperplasia , a common, non-cancerous enlargement of the prostate gland.

If you experience these symptoms, visit your doctor.

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