What Does Prostate Cancer Screening Entail
There are two types of prostate cancer screening exams and both should be done in conjunction with the other: A digital rectal exam and a prostate-specific antigen blood test .
A DRE is a physical exam in which the physician lubricates a gloved finger to gently examine the patients rectum. If it is enlarged or irregular in shape, the doctor will be able to easily detect it. While it may be uncomfortable, the test brief and can be life-saving.
A PSA test is a blood test that measures the level of prostate-specific antigens in the blood. Rising levels of PSA can be one of the first signs of prostate cancer, allowing for early detection and treatment.
When To Start Prostate Exams
The American Cancer Society recommends that men aged 50 start prostate cancer screenings. However, African American men and men with a family history of prostate cancer should start screening at age 45. In general, most experts recommend getting a prostate exam every three to five years.
Your doctor will check the prostate gland for any lumps or abnormalities during a prostate exam. It’s not painful, but some men may feel uncomfortable during the exam.
These are some types of prostate exams:
- Digital Rectal Exams : During a DRE, the doctor physically examines the rectum to feel for any abnormalities in the prostate. This exam can help detect prostate cancer in its early stages
- Prostate-Specific Antigen Tests : A PSA test measures the level of PSA, a protein produced by the prostate present in the blood. A high PSA level may be a sign of prostate cancer
If any of the above tests is abnormal, further testing may include:
- Biopsies: A needle is used to sample tissues for cancer cells. This is typically done as an MRI-guided biopsy.
- Imaging exams
- Screening Tests: Screening tests can sometimes have incorrect or unclear test results, making it essential to speak with your doctor about the risks and benefits of this test. Men should talk to their doctor about how often they should get a prostate exam, depending on their health status.
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.
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When Should I Call My Healthcare Provider
If youre 50 and you havent had your first prostate exam yet, call your healthcare provider to set up an appointment. If youre at higher risk, such as if you’re Black or prostate cancer runs in your family, you should have your first prostate exam by age 45.
Furthermore, if you develop symptoms of urinary tract obstruction, schedule a visit with your provider right away. This may indicate an enlarged prostate, benign prostatic hyperplasia or a urinary tract infection.
A note from Cleveland Clinic
Most people are understandably apprehensive about their first prostate exam. Learning all you can about the process can help abate any fears or uncertainties you have. Talk to your healthcare provider about your screening options. A prostate exam is the first step in the early detection of prostate cancer and early detection is key to successful treatment.
Last reviewed by a Cleveland Clinic medical professional on 04/04/2022.
References
When To Get Your Prostate Checked: Warning Signs And Advice
A healthy prostate plays a vital role in male fertility, producing fluid that helps keep sperm alive. But as you get older, particularly after the age of 40, you may find that your prostate starts to cause you problems. One reason for this is that the prostate continues to grow as you age. This is a normal process but for many men, an enlarged prostate can cause symptoms that affect their quality of life. This isnt the only problem that affects the prostate, there are several other prostate issues, which can produce similar symptoms to each other. A prostate exam can help you find out whats going on with your prostate so your doctor can then help you get relief from any symptoms you may be experiencing.
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Why Prostate Exams Are Important
Prostate cancer is one of the most common cancers in men. A prostate exam can reveal very valuable information about your overall health and also detect cancer as early as possible. Additionally, prostate cancer is very slow-growing and asymptomatic until very advanced stages. If not detected early enough, treatment will be a lot more difficult and chances of survival will decrease drastically.
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 hasn’t recommended rectal exams because there has yet to be a randomized trial in which some men get the rectal exam and some don’t. 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. It’s part of the evaluation that we use even if it’s 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 hasn’t been studied,” Dr. Freedland adds. “Most people are screened with PSA and DRE.”
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How Often Should You Get A Prostate Exam
How often should you get a prostate exam? Avoidance is always better than cure. We all know this thing very well, but how many of us are those who follow these things? As the age of a person increases, a lot of health related problems start to appear in his body.
The best way to avoid this is to have a medical screening and physical examination of your entire body at least once a year. An annual examination of the body does not only mean that diseases can be identified and treated, but whether all the organs of the body are functioning properly or not.
Routine annual check-ups are also called preventive care and help in symptomatic therapy. After any malfunction inside the body, the body gives a lot of signals which are easy to identify and diagnose on time. However, there are some tests that should be done after the age of 50.
Tests For MenBlood cholesterol test
A simple test and preventive measure assesses the condition of any type of heart disease you may have. This test shows the level of cholesterol and teryglycyride in the blood. Due to abnormal levels of cholesterol and triglyceride in the blood, the risk of heart attack and other types of heart disease increases many times.
How often should you get a prostate exam?
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.
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What Does A Prostate Exam Feel Like
Alt-text: Doctor explains senior man about prostate exam
A prostate exam necessitates physical contact in an area that is intimate and sensitive. That being said, doctors performing the test take all the necessary precautions to reduce the risk of any pain.
For this reason, doctors handle the exam equipped with gloves and lubricant. The moves performed within the rectum consist of gentle gestures meant to feel the area. All in all, the procedure lasts no more than 10 minutes and there is no lingering pain. Patients are feeling momentary disconfort during their prostate exams. There might also be a tingling sensation of the need to urinate.
Nonetheless, these sensations are unlikely to persist after the procedure. At the end of the prostate exam, the doctor is ready to inform on the condition of the prostate gland, whether it is of normal size or enlarged.
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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What Age Should I Start Getting A Prostate Exam
For African-American men and men with a family history of prostate cancer, it is recommended that tests be given starting at age 40. If you have urination problems or if the DRE or PSA test indicates that you might have a problem, you will probably be given additional tests that may require some preparation.
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What Age Should I Get A Prostate Exam
Prostate exams are an essential basic health screening test that everyone at risk of prostate cancer should consider. Current American Cancer Society guidelines suggest that men over the age of 50 should speak with their primary care physician about getting screened routinely for prostate cancer. This guideline may change depending on your risk for prostate cancer.
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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 screening 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.
Finding Prostate Cancer Early
There is no national screening program for the early detection of prostate cancer. Doctors have different opinions about whether all men without symptoms of prostate cancer should be tested.
There is concern that testing healthy men will cause unnecessary harm and lead to treatments that may not offer long-term benefits. Treatment for prostate cancer can leave men with side effects such as erectile dysfunction and continence issues, which can affect their quality of life.
Testing may identify fast-growing or aggressive cancers that have the potential to spread to other parts of the body and would benefit from treatment. It may also detect very slow-growing cancers that are unlikely to be harmful.
Weigh up all the risks and benefits before deciding whether to be tested for prostate cancer, particularly if you dont have symptoms. Talking to your doctor can help.
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Why Prostate Screening Is Important To Discuss After Age 55
Prostate cancer is both treatable and curable. Yet, this year, it will claim the lives of almost 30,000 men, according to the American Cancer Society.1 Screening via prostate exams and a blood test can ensure early detection and treatment. Heres why prostate cancer screening is important to discuss for all men over 55 years old.
Prostate Exam Vs Colonoscopy: Whats The Difference
At first glance, it might seem that a prostate exam is similar to a colonoscopy. After all, both exams involve your rectal area. However, these two tests are quite different.
While a prostate exam involves feeling the prostate with a gloved finger, a colonoscopy examines the walls of your colon by inserting a flexible camera into your rectum. The prostate is not examined at all during this procedure unless your healthcare provider manually performs an exam.
A prostate exam is a fairly quick procedure performed in an office setting. A colonoscopy, on the other hand, is an outpatient procedure in the hospital that requires IV sedation.
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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.
What Age Should Men Be Screened For Prostate Cancer
The Prostate Cancer Foundation recommends that Black men or men with a family history of cancer be screened at the age of 40 otherwise, the organization advises getting screened at 45. The American Cancer Society recommends that men at “average risk” be screened at the age of 50, while “men at high risk of developing prostate cancer” like Black men and men who have a first-degree relative, like a father or brother, who were diagnosed with prostate cancer before the age of 65, be screened at 45. Men at “even higher risk” should be screened at 40.
In 2018, the U.S. Preventive Services Task Force issued a recommendation advising men to start talking about screenings with their doctors at the age of 55.
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What Is A Digital Rectal Exam
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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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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