How Should I Prepare For The Exam
Your blood must be sent to a laboratory for analysis, so your PSA results wont be available immediately. Your doctor will let you know when they have the results.
The lab report will show the level of PSA in your blood as:
In addition to looking at the amount of PSA in your blood, your doctor will assess how quickly this number is changing. Many things can affect PSA, so test results require careful analysis by an expert. Your doctor will take all of your health information into account.
If you have an abnormal PSA test result, it doesnt mean you have prostate cancer. Most men with a high PSA level dont have prostate cancer. About of men who have a biopsy due to a high PSA level have prostate cancer.
Its also possible for men with prostate cancer to have normal DRE and PSA test results.
Risks And Benefits Of Prostate Cancer Screening
There are two main benefits of prostate cancer screening.
One is potentially preventing death from prostate cancer. Many men have prostate cancer without experiencing symptoms, so screening can potentially identify prostate cancer early on when it can be treated more easily.
Another benefit of screening and early detection is potentially catching prostate cancer in its early stages, allowing for more effective treatment. Earlier treatment can help prevent prostate cancer from spreading beyond the prostate , which can cause several symptoms.
Unfortunately, there are drawbacks to prostate cancer screening. The DRE is not very sensitive or specific. This means that people who have prostate cancer can still have a normal DRE, while patients with an abnormal DRE may not have prostate cancer. For these reasons, healthcare providers are no longer performing DRE alone for routine prostate cancer screening and relying instead on the PSA test .
PSA testing also has limitations in screening for prostate cancer. Elevated PSA levels do not only occur in prostate cancer. Prostatitis or an enlarged prostate can also cause PSA levels outside the normal range. Abnormal test results can ultimately lead to undue anxiety and further testing that may prove unnecessary .
Another problem with the PSA test is the potential for overdiagnosis and overtreatment. Screening uncovers patients with prostate cancer who would otherwise never have had any issues resulting from the disease.
What Are We Looking For
Many men experience issues with their prostate gland as they age. The symptoms for benign prostate enlargement and prostate cancer are very similar – most men present first with urinary issues. When your prostate has simply enlarged the surface is usually smooth. We begin to suspect prostate cancer when the surface is hard and lumpy. It’s a key difference and the best way to find out is via a rectal exam.
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What Do The Dre Results Mean
A digital rectal examination is a test used to see if you might have a prostate problem or prostate cancer.
Your prostate may feel:
- normal a normal size for your age with a smooth surface
- larger than expected for your age this could be a sign of an enlarged prostate
- hard or lumpy this could be a sign of prostate cancer.
The DRE is not a completely accurate test. Your doctor or nurse cant feel the whole prostate. And a man with prostate cancer might have a prostate that feels normal.
What Happens After A Prostate Exam
After the exam, the doctor can tell you straight away whether everything felt normal with your prostate. However, sometimes the prostate can feel fine even though there might be a problem. It can also have abnormalities caused by something other than cancer, such as inflammation or benign prostate enlargement.
This is why your prostate exam is often combined with a blood test called a PSA test. It looks for levels of a certain enzyme, which, if higher than normal, can be a sign of cancer.
It usually takes between 1-2 weeks to get the results back. Your prostate exam and PSA will determine whether any further tests are needed and help the doctor decide how regularly you need to be checked in the future.
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How Can You Prepare Yourself For A Prostate Exam
It takes little to prepare yourself for a prostate exam. Theres no need to change your bowel habits before youre due for the said exam. You can defecate before your appointment if you feel like doing so, and the exam itself will not increase your urge to move your bowels.
If everything checks out, then you only need to remember to come back for a follow-up prostate exam in the next 3 to 5 years. If the doctor detects anomalies in the digital rectal exam or if your PSA levels are abnormally high, however, you may be recommended to undergo further evaluation.
Prostate cancer is easy to treat before it spreads. In fact, about 99 per cent of all men who have been diagnosed with prostate cancer will survive for more than 5 years after their initial diagnosis. Early detection and treatment are key to this. If youre at risk for prostate cancer, then, dont hesitate to talk to your doctor about it and schedule an appointment to get your prostate checked. And if you have any concerns about the prostate exam, your doctor will gladly walk you through the process to help you feel more confident about undergoing this important and necessary evaluation.
Moving Into The Full Examination
When getting a preventative prostate exam, the staff will administer two tests for you. The two tests are known as a Digital Rectal Exam and a Prostate Specific Antigen Blood Test. It is crucial to participate in both tests, as certain abnormalities may be found in one test while missing the other completely.
A DRE involves the dreaded procedure that typically scares men away from taking care of their long-term health. This exam involves a physician wearing a lubricated glove and inserting their pointer finger into the rectum. While it may be uncomfortable to lie down on your side, the actual process is painless. A hurt sense of dignity is better than a life-changing illness. It is very important to get this portion of the test done, as feeling for physical abnormalities can show some of the earlier symptoms of prostate cancer.
Important Note: After going to a few prostate check-ups, your doctor might notice slight changes in-between visits. This can create false-positives and cause worry. These changes in the prostate do not necessarily indicate cancer, which is why it is important to partake in both examinations for clarity of mind.
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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.
Questions To Ask Your Health Care Team
Before having a DRE, you may want to ask these questions:
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Why do you recommend that I have a DRE?
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What happens during the DRE?
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Who will do the DRE?
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How long will the DRE take?
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Can a DRE find cancer?
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When and how will I get my test results?
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Who will explain them to me?
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Will I need more tests, such as a colonoscopy or a barium enema, if the DRE suggests cancer?
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Mri Ultrasound Targeted Prostate Biopsy
Magnetic resonance imaging guided biopsies are also being used more frequently, with ultrasound or alone, to help guide a prostate biopsy. MRI scans are capable of revealing potentially cancerous areas in more detail than ultrasound.
Studies have emerged suggesting that fusing the two techniques using MRI to identify suspicious areas before the transrectal ultrasound and biopsy procedure might identify cancer more accurately than a TRUS biopsy alone. For example, a landmark study led by researchers at the National Cancer Institutes urologic oncology branch found that the MRI-fused ultrasound technique detected more aggressive prostate cancer and fewer low-risk prostate cancers.
A joint statement issued by the American Urological Association and Society of Abdominal Radiologists supports fused MRI-ultrasound for men on active surveillance men who, along with their doctors, have opted to watch a slow-growing cancer rather than treat it aggressively and for men who have received elevated PSA test result but whose previous biopsies have tested negative for cancer. 30659-0/fulltext” rel=”nofollow”> 4)
Results And Follow Up
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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Who Should Be Screened
Prostate cancer is most common in older men, and rates are highest in men aged 75-79. Statistics show that ethnicity is a risk factor and black men are more likely to develop it. Youre also more at risk if a close relative has had it before they reached the age of 65.
As it develops without symptoms, its a good idea to get screened from the age of 50.
If you are at a very high risk eg if youve got more than one close relative who has developed prostate cancer before they reached 65, you should start getting screened at 40.
If you are black or you have one close relative who developed prostate cancer at a young age, you should start getting screened at 45.
What To Expect With Prostate Screening
If youre a man, prostate screenings play a key role in your ongoing health. At least one in eight American men develop prostate cancer at some point in their lives, and by age 60, more than 50% of men have an enlarged prostate.
The numbers only go up as you age, and at least 90% of men age 80 have this condition.
At Urology Associates Medical Group in Burbank, California, our providers use prostate screenings to monitor the health of your prostate and ensure you get the treatments you need as soon as possible.
Like many of our patients, you may feel anxious, worried, or scared about your first prostate screening. Dont let this concern prevent you from getting the exam. Without this screening, its difficult for us to catch any issues before they become serious.
Rest assured that prostate screenings are quick and painless. To help put your nerves at ease, weve created this short guide, which covers everything you need to know about prostate screenings.
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Why Should I Get Both Prostate Cancer Screenings
Both screenings provide valuable information about your health that can detect prostate cancer, even at an early stage. One result without the other may not provide enough indication of whether or not treatment is necessary.
There are many reasons why a mans prostate may be enlarged, and prostate cancer is only one. When paired with a PSA blood test, results can better indicate whether further testing is needed to determine a diagnosis.
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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How Does A Prostate Exam Feel
A prostate exam can cause some discomfort but it will be over before you know it. It feels like a slight pressure in your bottom and sometimes like you need to pee.
Some people worry about having an accident or becoming aroused, but the exam is over so quickly that theres not much time for anything like this to happen. If you feel nervous, let your doctor know and they can talk to you about your concerns.
What Are The Most Common Diagnoses You Find In Patients
As a sexual health specialist, I see erectile dysfunction, low testosterone and male infertility.
One of the most surprising things I find in many patients is Peyronies disease penile curvature that develops due to trauma. This is quite common but rarely talked about. Patients who come in for this often have never heard of it, and many of them think they are the only person who has this.
This disease causes painful erections, and many men opt not to treat it out of a sense of shame. But if you suspect you have it, early treatment can help limit or improve symptoms. Peyronies disease generally does not go away on its own, so please talk to a urologist if you notice any symptoms.
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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 Happens After A Prostate Screening
This depends on whether we notice an abnormality during your screening. If the results of your screening are normal, no follow-up is needed until your next exam. Most men have regular prostate screenings every year, but always follow your doctors recommendations.
If we identify a problem with your prostate, either through the PSA blood test or the DRE, you may need additional testing. Depending on the nature of the results, these tests may include:
- Additional PSA testing
Based on the results of your tests, we create a personalized treatment plan. To set up a prostate screening or to learn more about the process, schedule an appointment today at Urological Associates Medical Group in Burbank, California.
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What Should You Expect During A Prostate Exam
Its not unusual for patients to feel intimidated, scared, or embarrassed when going in for their first prostate exam, but rest assured that this is a routine exam for medical practitioners. Its perfectly fine to voice your concerns to your doctor so that they can adequately address any questions you may have about the procedure or the condition that you are being screened for. Before the digital rectal exam, a blood sample will be taken from you to assess the level of your PSA.
Upon being guided to the examination area, you will be asked to assume one of these positions: either lie on your side and hug your knees to your chest or bend at the waist while standing. Then, the doctor will gently insert a lubricated and gloved finger into your rectum. During this process, one of the doctors hands will be pressed on the prostate, while the other will be placed in the pelvic area. This can be an uncomfortable situation, but its usually not painful, and it only lasts a few moments.
The doctor will feel whether or not the back portion of your prostatethe part where many cancers start growinghas lumps or bumps. After the digital rectal exam, the doctor can tell you if your prostates shape and size are normal or if its enlarged or inflamed. A PSA, on the other hand, will reveal if you have a prostate infection.
The Prostate Exam Procedure
Your doctor will likely begin by asking if you are currently experiencing any prostate health related symptoms such as a weak urine stream, dribbling or straining to urinate. Your doctor may also inquire as to whether your family has a history with prostate cancer, and if the doctor doesnt ask, volunteer the information. Here are the two tests that will be done:
- Digital rectal exam :A digital rectal exam is a clinical examination of the prostate gland by way of the rectum to check for any abnormalities and is an essential element in screening for and identifying prostate cancer. While the exam can be uncomfortable, if not a little undignifying, a rectal exam shouldnt hurt.
- PSA blood test:A visit for a prostate exam may also involve a blood test, The PSA test is a blood test which is used primarily to screen for prostate cancer. The test measures for the amount of prostate-specific antigen in your blood which is a protein produced by both cancerous and noncancerous tissue in the prostate. Following the completion of the blood test it may take a few days to get the results.
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