Use In Men Already Diagnosed With Prostate Cancer
The PSA test can also be useful if you have already been diagnosed with prostate cancer.
- In men just diagnosed with prostate cancer, the PSA level can be used together with physical exam results and tumor grade to help decide if other tests are needed.
- The PSA level is used to help determine the stage of your cancer. This can affect your treatment options, since some treatments are not likely to be helpful if the cancer has spread to other parts of the body.
- PSA tests are often an important part of determining how well treatment is working, as well as in watching for a possible recurrence of the cancer after treatment .
Great News For Guys: No More Invasive Prostate Exams
Good news for all the over-40 men out there: we dont need routine screening for prostate cancer. More to the point, we dont need to subject ourselves to the dreaded digital rectal exam that has been a standard procedure for decades. Most guys dont need any encouragement to avoid this particular invasive procedure, but now theres good scientific evidence saying we dont need it.
One of the most widely used screens for prostate cancer is the PSA test. I wrote about this last year, after several studies and a thorough review concluded that
there is moderate certainty that the benefits of PSA-based screening for prostate cancer do not outweigh the harms.
Now, the Choosing Wisely campaign and the American Academy of Family Physicians have included not only PSA testing, but also digital rectal exams as procedures that are usually unnecessary. Their advice to physicians is very clear:
Dont routinely screen for prostate cancer using a prostate-specific antigen test or digital rectal exam.
So guys, the next time you go to the doctor, dont let him give you the PSA test or the dreaded digital rectal exam. If your physician hesitates , and hand it to him. If you or your doctor want to know more, the list includes references to long, detailed summaries of the evidence.
Men: Cancer Screening Exams By Age
These exams are for men at average risk of cancer.
Take this checklist to your next doctors appointment. Your doctor can help you develop a more tailored screening plan if needed.
These exams are for men at average risk of cancer. If you believe you may be more likely to develop cancer because of your personal or family medical history, visit our screening guidelines page to learn about exams for men at increased risk.
- Beginning at age 40, you should speak with your doctor about the benefits and limitations of prostate screening.
- If you choose prostate cancer screening, you should get a digital rectal exam and PSA test every year starting at age 45 to check for prostate cancer if you are African American or have a family history of prostate cancer.
- If you choose prostate cancer screening, you should get a digital rectal exam and PSA test every year to check for prostate cancer
- Colonoscopy every 10 years or virtual colonoscopy every 5 years to check for colorectal cancer
Age 76 and older
If youre age 76 to 85, your doctor can help you decide if you should continue screening. MD Anderson does not recommend cancer screening for men age 85 and older.
Regardless of your age, practice awareness. This means you should be familiar with your body so youll notice changes and report them to your doctor without delay.
Read Also: Why Do People Get Prostate Cancer
What If My Test Results Are Abnormal
If the results of early detection tests like the PSA screening or the digital rectal exam suggest that you might have prostate cancer, your doctor will conduct further testing. The PSA may be repeated, or you may be sent to a specialist for more tests such as a transrectal ultrasound and a prostate biopsy.
In a prostate biopsy, a tissue sample is taken from your prostate. Cancer can only be diagnosed with a tissue sample.
Recent research has yielded additional tests in addition to the PSA, DRE, and biopsy that can give a doctor more information to determine the probability of both finding cancer during a biopsy and determining how aggressive that cancer is likely to be. Read more on those tests.
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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What Is A Psa Exam
A PSA exam usually comes after DRE with the purpose of measuring the quantity of Prostate-Specific Antigen in the blood. Only 2 sources produce this type of protein in the male body: the prostate gland and a prostate tumor. Any reading that reveals an abnormal quantity of the PSA protein in a patient is going to prompt doctors to further investigate for signs of prostate cancer.
This blood test cannot be taken as an official prostate cancer diagnosis. Thats because there might be other explanations for the increased number of PSA. An inflamed prostate or certain medications can generate more PSA protein than usual which can mislead doctors. Therefore, a PSA exam result with unusual readings leads to further examinations instead of a diagnosis.
What Happens During A Digital Rectal Exam
Your health care provider will insert a gloved finger into the rectum and feel the prostate for hard, lumpy, or abnormal areas. The test takes only a few minutes to complete.
You may feel slight, momentary discomfort during the test. The procedure does not cause significant pain or any damage to the prostate.
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What Doctors Give Prostate Exams
Ask U.S. doctors your own question and get educational, text answers â it’s anonymous and free!
Ask U.S. doctors your own question and get educational, text answers â it’s anonymous and free!
HealthTap doctors are based in the U.S., board certified, and available by text or video.
Medical History And Physical Exam
If your doctor suspects you might have prostate cancer, you will be asked about symptoms you are having, such as any urinary or sexual problems, and how long you have had them. You might also be asked about possible risk factors, including your family history.
Your doctor will also examine you. This might include a digital rectal exam , during which the doctor inserts a gloved, lubricated finger into your rectum to feel for any bumps or hard areas on the prostate that might be cancer. If you do have cancer, the DRE can sometimes help tell if its only on one side of the prostate, if its on both sides, or if its likely to have spread beyond the prostate to nearby tissues. Your doctor may also examine other areas of your body.
After the exam, your doctor might then order some tests.
Read Also: Do Doctors Still Do Prostate Exams
There Are Risks To Getting Prostate Cancer Tests And Treatments
If your PSA is not normal, you will probably have a biopsy. The doctor puts a needle through the wall of the rectum and into the prostate to take a few samples. Biopsies can be painful and cause bleeding. Men can get serious infections from biopsies, and they may need hospital care.
Surgery or radiation are the usual treatments for prostate cancer. They can do more harm than good. Treatment can cause serious complications, such as heart attacks, blood clots in the legs or lungs, or even death. In addition, 40 men out of 1,000 will become impotent or incontinent from treatment.
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 .
On this page
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What Happens After The Exam
When abnormalities are found with the rectal exam, the doctor will order a PSA test. After the results for PSA testing are returned, the doctor will analyze the measurements of prostate-specific antigen in the patients blood.
The findings of the PSA test determine what the doctor will do next.
If the doctor suspects prostate cancer, other tests may be requested. A transrectal ultrasound is often requested. This gives the doctor a visual view of the patients prostate gland.
Cancerous growths can be observed through this type of ultrasound test. The test is also relatively quick to perform. Men may experience discomfort when an ultrasound is performed. The discomfort should not last long, however.
A Great Health Resource For Men
The Mens Maintenance Guide ebook provides a straightforward, common-sense health-maintenance checklist based on your age. Guys aged 40-54 should start having their prostate health checked every two years, or based on their doctors recommendations. For more tips on what to check and when to check it, today!
What funny moments have you had with your doctor? Share your experience in the comments below.
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At What Age Should You Get Your Prostate Checked
Its important to understand what a difference routine screening can make in a persons quality of life. The sooner prostate cancer is detected, the better the odds are for a full recovery.
Therefore, the screening method for prostate cancer doesnt start with the feeling of discomfort in the penile area. Instead, it starts when men are seemingly in a healthy condition, but they approach a certain age when it is likely to appear early signs of prostate cancer according to statistics.
Therefore, the number of prostate cancer diagnosis recorded in the last 10 years indicate that men should consider periodic prostate tests at the age of 50. In some cases, where the family history indicates a genetic predisposition to prostate cancer cells, general doctors can prescribe their patients routine prostate exams at age 45.
What Happens After A Prostate Exam
The doctor can tell you right after a prostate exam his or her observations at first hand. However, doctors need further test results to confirm their premises.
In case your doctor finds an abnormal aspect of the prostate gland, the next step is the recommendation for further tests. These can be a biopsy, sigmoidoscopy, colonoscopy, or proctoscopy. For these tests, you will need a second appointment.
There may also be a PSA test, which the doctor can perform right away. It can take one to two weeks to receive the results for a PSA test.
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Who Should Get A Prostate Exam
Men should understand the importance of a prostate exam. This will help men determine when it is essential for them to get a digital rectal exam .
Age is one of the most important risk factors associated with prostate problems. The risk tends to increase once a man reaches the age of 40. Thus, men over 40 should ensure they get regular health screening. The man should also provide a prostate exam as part of the health screening.
This becomes especially important once the man reaches the age of 60. The majority of prostate problems occur in men of this age and older. Thus, at the age of 60, a man should never delay a prostate exam.
There are other reasons for men to get a prostate exam, apart from age.
Men who experience certain symptoms should ensure they get a prostate exam. A man should educate himself on common symptoms associated with prostate problems.
The sooner the prostate exam is done once the symptoms appear, the earlier a diagnosis can be made.
Most prostate conditions will cause an enlargement of the gland. Sometimes inflammation may affect the gland instead. The prostate gland is situated directly beneath the bladder. It also surrounds the urethra. This is why men will usually experience lower urinary symptoms when they have a prostate problem.
What Happens During Your Gp Appointment
Your doctor needs to build up a picture of what’s going on. So they will ask you some questions. They will ask you about your general health and any other medical conditions you have. They may ask you about any urinary symptoms you may have.
During the appointment your doctor may want to examine you. You can ask for someone else to be in the room if you want, to act as a chaperone. This chaperone can be a friend or relative, or a trained health professional such as a practice nurse. They can be with you during the examination or throughout the appointment.
If you would rather see a male or a female doctor it is worth asking when you book the appointment.
Recommended Reading: How To Make Your Prostate Healthy
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.
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.
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Questions You Might Want To Ask Your Gp
- Do I need to see a specialist? Is it urgent?
- When will I see them?
- Where will I see them?
- Will I find out about my appointments by post or telephone?
- Do I need tests? What will they involve?
- How long should I expect to wait?
- Where can I find out more about tests?
- Do I have to do anything in preparation for this test?
- When will I get the results and who will tell me?
Your GP might not be able to answer all of your questions. They will tell you what they can at this point. Not knowing is difficult to cope with and can make you anxious.
Speaking to a friend or relative about how you feel might help.
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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.
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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.