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How Does A Urologist Check For Prostate Cancer

Cystoscopy Procedure For Your Prostate

PSA Test For Prostate Cancer

The urologist may insert a camera catheter, also known as a cystoscopy procedure, to do a prostate examination if they suspect a serious problem.

Also known as a bladder scope, the camera allows the doctor to see the inside of the prostate and bladder. An enlarged prostate can cause problems in the bladder, and a cystoscopy procedure can enable your doctor to see whats going on inside your prostate and bladder.

This procedure enters not through the rear as in a normal DRE but the front down the penis inside the urethra through the prostate gland and into the bladder.

The cystoscope has lenses that allow your doctor to see inside the prostate, bladder and urinary tract. The images usually appear on a computer screen as she guides the scope.

The cystoscope has lenses that allow your doctor to see inside the prostate, bladder and urinary tract. The images usually appear on a computer screen as she guides the scope.

Cystoscopes come in different sizes: from the thickness of a pencil, to approximately 9mm and have a light at the tip. Many cystoscopes have extra tubes to guide other instruments for surgical procedures to treat urinary problems.

Yup, this one can hurt especially if done fast, as my urologist did! The catheter and camera size are not small. They did use a local anesthetic gel, xylocaine, but it did not make much difference to me.

This will ease with each urination. Some blood spotting is also possible but this too will pass.

Commonly Performed Urology Tests

If you need to get a urology test done, its probably a good idea to understand what urology is. Simply put, urology is a branch of health care that deals with male and female urinary tracts1. It involves the kidneys, ureters, bladder, and urethra. Urology also includes the male organs used in reproduction, but excludes the female organs.

Urology, at its core, is a surgical specialty that helps to deal with the diseases of both male and female urinary tracts1. Urinary tract problems are possible regardless of age, so if you feel like youre having problems or things arent regular, its time to see your urologist. When you make an appointment to see your urologist, there are a number of commonly performed tests used in diagnosing the underlying problem. In this article, well discuss some of the most commonly performed urology tests used in the office. Based on the results of the test, further monitoring, care, or surgery is recommended and you and your doctor will discuss the best plan of action for your circumstances.

Can I Check For Prostate Cancer At Home

It is strongly advised under any circumstances not to self-examine for prostate cancer at home either by yourself or with a partner. Not only does it take a skilled professional to assess how the prostate feels to make an accurate determination of overall prostate health, self-examinations have the potential to cause injury.

âSince the prostate is an internal gland, itâs extremely important that only licensed medical professionals conduct the exam. At-home self-exams should not be administered in order to avoid injury or self-harm. Regular screening is important for prostate cancer, as the disease often does not present symptoms until it is too late. Talk to your doctor about making sure you receive a regular DRE check-up at each visit.â

While actually screening yourself for prostate cancer at home is ill advised, you can still monitor your risk factors for prostate cancer between yearly check-ups, like practicing a healthy diet and exercising regularly.

Read Also: What Are The Symptoms Of Perineural Invasion

Also Check: How Do You Treat An Enlarged Prostate

Other Factors That Influence Psa Levels

The PSA blood test alone cannot diagnose prostate cancer. It is possible, although rare, to have prostate cancer without raised PSA levels in the blood. A higher-than-normal PSA level doesnt automatically indicate prostate cancer either. A high PSA level is due to cancer in around one in three cases.

PSA levels can be raised by other factors, including:

  • , also known as benign prostatic enlargement .

For this reason, the PSA blood test isnt used in isolation when checking for prostate cancer.

Prostate Cancer Urine Test

Prostate Cancer Symptoms? PSA Test Is Only Part of the ...

This test detects the gene PCA3 in your urine and can also help your doctorbetter assess your prostate cancer risk.

PCA3 is a prostate-specific noncoding RNA. Its a gene thats only in yourprostate. If the gene is overexpressed , then theres a greater chance you have prostate cancer.

Like PSA and PHI tests, this isnt definitive, either. But data suggestthat when cancer is present, the PCA3 will be positive 80 percent of thetime. This test can also help your doctor determine whether a biopsy isnecessary.

Both of these new tests are more accurate than the PSA test. Your doctormay recommend one or more than one, based on the specifics of your case.

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Your Urologist What To Expect

The digital rectal examination is less effective than the PSA blood test at finding prostate cancer but it can sometimes find cancer in men with normal PSA levels.

Some GPs also offer a prostate specific antigen test before referring a patient to a specialist while others prefer the urologist to do this. PSA is a protein produced by the prostate gland and is made by normal and cancer cells. PSA levels tends to rise if you have any problems with your prostate.

Yes Urologists See Women Too

We dont discriminate against either sex both men and women can develop bladder problems, kidney stones, and UTIs, says Dr. Gill.

Generally, about two-thirds of the patients urologists see are men, and about one-third are women. But this is very practice-specific, and can vary based upon a doctors specialty training.

We focus on taking care of the whole patient, and on providing high-quality treatment and working toward a good quality of life for everyone we see, he says.

Some men prefer to see a male urologist, while some women prefer to see a female urologist. Dr. Gill says this can also go the other way.

The quality of care will be the same, he notes. Furthermore, if a guy feels bashful around female staff, he should always remember that what hes coming in with is nothing they havent seen before.

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Other Conditions That Can Cause Urinary Symptoms

  • Benign prostatic hyperplasia BPH is when the prostate gland grows larger. BPH is common in middle-aged and elderly men because the prostate gland often gets bigger as you get older. BPH is not cancerous but it may cause prostate urinary symptoms.
  • ProstatitisProstatitis means that the prostate gland has become inflamed. It can be caused by an infection in the prostate gland. It is not a form of prostate cancer. Symptoms can include pain in your testicles, pain when passing urine or an uncomfortable feeling when sitting down.

How Is Prostatitis Treated

PSA test for prostate cancer

Treatment depends on the type of prostatitis.

Chronic prostatitis/chronic pelvic pain syndrome. Treatment for chronic prostatitis/chronic pelvic pain syndrome aims to decrease pain, discomfort, and inflammation. A wide range of symptoms exists and no single treatment works for every man. Although antibiotics will not help treat nonbacterial prostatitis, a urologist may prescribe them, at least initially, until the urologist can rule out a bacterial infection. A urologist may prescribe other medications:

  • silodo
  • cans such as chondroitin sulfate
  • muscle relaxants such as cyclobenzaprine and clonazepam
  • neuromodulators such as amitriptyline, nortriptyline , and pregabalin

Alternative treatments may include

  • warm baths, called sitz baths
  • local heat therapy with hot water bottles or heating pads
  • physical therapy, such as
  • Kegel exercisestightening and relaxing the muscles that hold urine in the bladder and hold the bladder in its proper position. Also called pelvic muscle exercises.
  • myofascial releasepressing and stretching, sometimes with cooling and warming, of the muscles and soft tissues in the lower back, pelvic region, and upper legs. Also known as myofascial trigger point release.
  • relaxation exercises
  • phytotherapy with plant extracts such as quercetin, bee pollen, and saw palmetto
  • acupuncture
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    When Is A Psa Test Needed

    If you are age 50 to 74, you should discuss the PSA test with your doctor. Ask about the possible risks and benefits.

    Men under 50 or over 75 rarely need a PSA test, unless they have a high risk for prostate cancer.

    • You are more likely to get prostate cancer if you have a family history of prostate cancer, especially in a close relative such as a parent or sibling.
    • Your risks are higher if your relative got prostate cancer before age 60 or died from it before age 75. These early cancers are more likely to grow faster.
    • If you have these risks, you may want to ask your doctor about getting the PSA test before age 50.

    This report is for you to use when talking with your healthcare provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.

    04/2014

    Imaging Tests For Prostate Cancer

    Imaging tests use x-rays, magnetic fields, sound waves, or radioactive substances to create pictures of the inside of your body. One or more imaging tests might be used:

    • To look for cancer in the prostate
    • To help the doctor see the prostate during certain procedures
    • To look for spread of prostate cancer to other parts of the body

    Which tests you might need will depend on the situation. For example, a prostate biopsy is typically done with transrectal ultrasound and/or MRI to help guide the biopsy. If you are found to have prostate cancer, you might need imaging tests of other parts of your body to look for possible cancer spread.

    The imaging tests used most often to look for prostate cancer spread include:

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    Your Psa Is Going Up Whats Going On With Your Prostate Good News: Second

    Your PSA is going up. Whats going on with your prostate? Do you need a biopsy? Or, maybe youve already had a biopsy that didnt find cancer, but your urologist is wondering whether you need another one. Whats the next step?

    Good news: You dont have to move directly to having needles stuck in your prostate! Its not the Monopoly bad-case-scenario of Do not pass Go, do not collect $200! There is a next step! Its a second-line test: a blood or urine test that can provide other layers of information beyond the basic PSA test. There are several good ones out there. Which one do you need? Well, as Marlon Brando said in the classic 1953 movie, The Wild One: Whadya got?

    Theres no shortage of options! There are blood tests that provide more nuanced information than the basic PSA test, plus urine tests and even, if youve already had a biopsy, molecular biomarker tests, which arent done on body fluids but on tissue samples. These tests can be helpful, not only in diagnosing cancer, but in risk stratification predicting which cancer is more likely to be aggressive, and which cancer is less likely to need immediate treatment.

    Now, about those other blood tests: In addition to the free PSA test, here are two more that include free and total PSA, but look for other factors, as well:

    • Copied

    Creatinine And Blood Urea Nitrogen Blood Tests

    Elevated PSA in Men

    The next type of blood test is a creatinine and blood urea nitrogen test, which is used to assess how the kidneys are functioning through creatinine measurement. When you have high levels of creatinine in your blood, its oftentimes an indication that your kidneys arent functioning properly or efficiently2. Depending on the ratio of creatinine to blood urea nitrogen, your urologist will be able to diagnose the problem.

    When your kidneys arent functioning well, the blood flow is thrown off. Sometimes, the problem is as simple as dehydration. Other times, its more serious and helps diagnose congestive heart failure2.

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    Genetic Risk Assessment Program

    The UCLA Genitourinary Cancer Genetic Risk Assessment Program focuses on investigation into the potential genetic causes of an individuals urologic cancer. Up to 5-10% of cancers are related to a genetic predisposition. If you have been diagnosed with a urologic cancer, UCLAs team has specific referral criteria to determine if you should pursue genetic risk assessment to evaluate for a genetic cause of cancer. For those at greatest risk, often this knowledge can more precisely tailor a treatment plan that is optimal for you.

    Questions To Ask The Doctor

    • What treatment do you think is best for me?
    • Whats the goal of this treatment? Do you think it could cure the cancer?
    • Will treatment include surgery? If so, who will do the surgery?
    • What will the surgery be like?
    • Will I need other types of treatment, too?
    • Whats the goal of these treatments?
    • What side effects could I have from these treatments?
    • What can I do about side effects that I might have?
    • Is there a clinical trial that might be right for me?
    • What about special vitamins or diets that friends tell me about? How will I know if they are safe?
    • How soon do I need to start treatment?
    • What should I do to be ready for treatment?
    • Is there anything I can do to help the treatment work better?
    • Whats the next step?

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    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 test 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.

    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. Learn more here.

    Possible Inaccurate Or Unclear Test Results

    PSA Testing for Prostate Cancer – Urology Care Foundation

    As an example, neither the PSA test nor the DRE is 100% accurate. These tests can sometimes have abnormal results even when a man does not have cancer , or normal results even when a man does have cancer . Unclear test results can cause confusion and anxiety. False-positive results can lead some men to get prostate biopsies when they dont have cancer. And false-negative results can give some men a false sense of security even though they might actually have cancer.

    Recommended Reading: How To Fix A Swollen Prostate

    What To Expect During Cystoscopy

    The procedure generally takes about 15 to 20 minutes.

    • Youâll need to pee first. The test is done with an empty bladder.
    • Youâll lie down. The position depends on the type of scope your doctor uses:
    • Standard rigid cystoscope. Youâll lie on your back with your knees up and apart. Your feet will probably be in stirrups.
    • Flexible cystoscope. No special position is needed. The doctor will help you find a comfortable position.
  • Youâll get medicine. You might get a drug to make you sleepy. The doctor will call this a sedative. Or you could get a general anesthetic to help you sleep through the entire procedure.
  • Your doctor inserts the scope. Theyâll clean your urethra and numb the area. The scope goes through the urethra and into your bladder. Theyâll use the smallest scope possible. They might need to use a bigger one to take samples or bring surgical tools into your bladder.
  • The doctor examines your urethra and bladder. The cystoscope has a lens on the end that works like a telescope. It makes it easier for the doctor to see inside your body. They might put a video camera over the lens to project images onto a screen.
  • The doctor fills your bladder. They put water or saline in through the cystoscope. When your bladder is full of water, it stretches. This lets the doctor see your entire bladder wall. Theyâll ask you how it feels when itâs full.
  • Is The Psa Test Recommended For Prostate Cancer Screening

    Until about 2008, some doctors and professional organizations encouraged yearly PSA screening for men beginning at age 50. Some organizations recommended that men who are at higher risk of prostate cancer, including African-American men and men whose father or brother had prostate cancer, begin screening at age 40 or 45. However, as more was learned about both the benefits and harms of prostate cancer screening, a number of organizations began to caution against routine population screening. Most organizations recommend that men who are considering PSA screening first discuss the risks and benefits with their doctors.

    Currently, Medicare provides coverage for an annual PSA test for all Medicare-eligible men age 50 and older. Many private insurers cover PSA screening as well.

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    If You Are Diagnosed With Bph

    Taken together, these tests will help your doctor determine whether you have BPH and if you do, how severe it is. If you have BPH, your doctor should provide you with information on whether simply monitoring your symptoms is a reasonable option, or whether treatment is a better option.

    BPH can be treated medically or surgically in some cases.

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