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How Is A Prostate Exam Done

How Accurate Is A Prostate Ultrasound

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

A prostate ultrasound is more accurate than an X-ray. This is because your technician can see the images as the transducer moves through your rectum rather than having to take a snapshot and develop the images. Ultrasound tests are also safer than X-rays because they dont produce any dangerous radiation.

A prostate ultrasound is also faster than a computed tomography test, which provides 3-D images of your prostate and the areas around it. CT scans require more preparation and time for testing, and they dont provide real-time images.

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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Tests To Diagnose And Stage Prostate Cancer

Most prostate cancers are first found as a result of screening. Early prostate cancers usually dont cause symptoms, but more advanced cancers are sometimes first found because of symptoms they cause.

If prostate cancer is suspected based on results of screening tests or symptoms, tests will be needed to be sure. If youre seeing your primary care doctor, you might be referred to a urologist, a doctor who treats cancers of the genital and urinary tract, including the prostate.

The actual diagnosis of prostate cancer can only be made with a prostate biopsy .

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Getting The Results Of The Biopsy

Your biopsy samples will be sent to a lab, where they will be looked at with a microscope to see if they contain cancer cells. Getting the results usually takes at least 1 to 3 days, but it can sometimes take longer. The results might be reported as:

  • Positive for cancer: Cancer cells were seen in the biopsy samples.
  • Negative for cancer: No cancer cells were seen in the biopsy samples.
  • Suspicious: Something abnormal was seen, but it might not be cancer.

If the biopsy is negative

If the prostate biopsy results are negative , and the chance that you have prostate cancer isnt very high based on your PSA level and other tests, you might not need any more tests, other than repeat PSA tests sometime later.

But even if many samples are taken, biopsies can still sometimes miss a cancer if none of the biopsy needles pass through it. This is known as a false-negative result. If your doctor still strongly suspects you have prostate cancer , your doctor might suggest:

  • Getting other lab tests to help get a better idea of whether or not you might have prostate cancer. Examples of such tests include the Prostate Health Index , 4Kscore test, PCA3 tests , and ConfirmMDx. These tests are discussed in Whats New in Prostate Cancer Research?
  • Getting a repeat prostate biopsy. This might include getting additional samples of parts of the prostate not biopsied the first time, or using imaging tests such as MRI to look more closely for abnormal areas to target.

Prostate cancer grade

Gleason score

How Soon Will Prostate Test Results Be Available

Prostate Cancer Can Soon be Diagnosed with A Simple Urine Test

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.

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At What Age Should Men Get A Prostate Exam

A prostate screening can help your doctor find prostate cancer early, but youll need to decide if the benefits of the exam outweigh the risks. Have a discussion with your doctor about prostate cancer screenings.

The U.S. Preventive Services Task Force now recommends that men ages 55 to 69 decide for themselves whether to undergo a prostate-specific antigen screening test, after talking it over with their doctor.

It recommends against screening for men at or above age 70.

The American Cancer Society strongly recommends that no one be screened without discussion of the uncertainties, risks, and potential benefits of prostate cancer screening.

The Prostate Cancer Foundation recommends that men practice precision screening, and consult with their doctor to come up with a personal prostate cancer screening plan thats right for them.

When to start this conversation depends on age and risk factors that may increase a mans risk of prostate cancer. Here are the general recommendations:

  • Age 40: men who have a family history of prostate or other cancers in a first-degree relative, are Black, or have known genetic mutations that may increase the risk of cancers
  • Age 45: men with no known risk factors

PSA screening should be considered carefully based on life expectancy, existing conditions, family history, and ethnicity. Side effects from some treatments can lessen life expectancy and quality of life.

A digital rectal exam may also be a part of your screening.

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However, suppose you are at a higher risk of prostate cancer or are experiencing urinary or sexual symptoms. In that case, you should have a discussion with your healthcare provider about prostate cancer screening sooner rather than later. People who may have a high risk of prostate cancer include :

  • African Americans
  • Men with a family history of prostate cancer or who have tested positive for BRCA1, BRCA2, or HOXB13 gene mutations
  • Men with symptoms like blood in the urine, painful or frequent urination, or sexual problemsthese may be signs of problems with the prostate, including prostate cancer.

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What Is A Prostate Exam

A prostate exam is a screening method used to look for early signs of prostate cancer. In general, a prostate exam includes a PSA blood test and a digital rectal exam .

During the digital rectal exam portion, your healthcare provider carefully inserts their gloved finger into your rectum. This allows them to feel the edges and surface of your prostate gland to detect any potential abnormalities.

What Is Cancer Screening

PROSTATE EXAM Procedure

Cancer is a disease when the cells of the body grow out of control. Cancer screening is having tests to look for signs of cancer before you have any symptoms. By the time cancer causes symptoms, it may have already spread to other parts of your body. A screening test may help find cancer early, when it may be easier to treat.

Cancer screening only tells you whether you might have cancer. It doesn’t diagnose cancer. If a screening test shows signs of cancer, you’ll need to have other tests to find out if you do have cancer and how serious it may be.

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What Tests Screen For Prostate Cancer

Two tests are commonly used to screen for prostate cancer:

  • A prostate-specific antigen test, also called a PSA blood test. PSA is a protein made by your prostate. A high level of PSA in your blood may mean you have prostate cancer, but it’s not proof of cancer. That’s because many other things may cause high PSA levels, including:
  • Having an enlarged prostate
  • Problems controlling your bowel movements
  • Repeating The Psa Test

    A mans blood PSA level can vary over time , so some doctors recommend repeating the test after a month or so if the initial PSA result is abnormal. This is most likely to be a reasonable option if the PSA level is on the lower end of the borderline range . For higher PSA levels, doctors are more likely to recommend getting other tests, or going straight to a prostate biopsy.

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    Can’t 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 what’s 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 it’s best used to check against the result of a rectal exam but can’t be relied upon in isolation.

    What Are Clinical Trials And Are They Right For You

    What to Expect During a Prostate Exam

    Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for you.

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    So Doc Which Grey Cup Did You Win

    Do you need an annual prostate exam? Probably not. This mostly depends on your age and if youre high risk. You may not look forward to Prostate Cancer Awareness Month like you do the Grey Cup. Still, every year the September-long event does highlight a wide range of great tips for keeping your prostate and the rest of you healthy and getting a prostate exam tops the list if youre in a high-risk category. Oh, and doctors always remove their rings while performing the exams.

    What Does The Psa Test Involve

    The PSA test involves taking a blood sample and sending it to a laboratory for analysis. The results indicate:

    • Normal levels: Most healthy adult males have PSA levels below 4 nanograms per milliliter .
    • Borderline levels: PSA levels of 410 ng/ml are borderline. There is a 25% chance that cancer is present, and the person will usually need additional tests.
    • High levels: If PSA levels are over 10 ng/ml, there is a 50% chance that the person has prostate cancer. The specialist will likely recommend more testing, including a prostate biopsy.

    It is important to note that PSA levels can naturally vary from person to person. A person with high levels may not have prostate cancer. On the other hand, about 15% of people who test positive for prostate cancer after a biopsy have PSA levels below 4 ng/ml.

    Prostate cancer is not the only cause of high PSA levels. Find out more about the other causes here.

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    Genetic Testing For Some Men With Prostate Cancer

    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.

    What Is A Digital Rectal Exam

    What you need to know in preparation for Prostate Biopsy

    The most common way for doctors to check on the health of your prostate is with a DRE. Its a fairly quick and simple procedure.

    For the exam, youll bend at the waist while standing or lie on your side with your knees bent toward your chest.

    Your doctor will lubricate a gloved finger and gently place it inside your rectum. Theyll press one hand on your prostate, and their other hand will feel your pelvic area. It should only take a few moments.

    You may experience momentary discomfort. You may also feel the urge to urinate, especially if your prostate is enlarged or inflamed.

    Your doctor will be able to tell you if your prostate seems to be a normal size and shape. In general, a DRE has no risks.

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    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:

    A Prostate Cancer Gene 3 Rna Test May Be Used For Certain Patients

    If a man had a high PSA level and a biopsy of the prostate did not show cancer and the PSA level remains high after the biopsy, a prostate cancer gene 3 RNA test may be done. This test measures the amount of PCA3 RNA in the urine after a DRE. If the PCA3 RNA level is higher than normal, another biopsy may help diagnose prostate cancer.

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    Are You Seeing Prostate Cancer Becoming More Prevalent In Younger Patients

    Its pretty rare. Its less common that men in their 40s have prostate cancer, but, we also are very rarely screening them. The young men who come in to be screened tend to have one of those high-risk features. They most likely had a father who had prostate cancer, so theyre nervous about it. Or theyre African-American, and theyve been flagged by their health care providers.

    If youre young, your quality of life is even more important to you right now. We know that, if diagnosed with low-grade prostate cancer, a person will need treatment at some time in life. If we can delay treatmentwhich could negatively impact urinary or sexual functionby several years, then we should do that and obviously discuss that there is a low but possible chance of metastasis developing during that time.

    Results And Follow Up

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    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.

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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 .

    Who Should Get A Prostate Exam

    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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