Health & Wellnessprostate Cancer Warning Signs: What Doctors Say You Need To Know
Dr. Behfar Ehdaie, a urologic surgeon specializing in prostate cancer at Memorial Sloan Kettering Cancer Center in New York, said that these varying guidelines are due to the different risk factors that each person faces. Things like family history, environmental factors, race and more can all come into play when it comes to assessing prostate cancer risk.
âThere are specific patient level factors that have to go into that decision, including family history, comorbidities, and life expectancy,â said Ehdaie, who said that people who are not expected to live more than another decade may not be advised to get screened. âAnd of course, the patientâs own preferences are taken into account, their goals, what they want to achieve.â
Living With Prostate Cancer
As prostate cancer usually progresses very slowly, you can live for decades without symptoms or needing treatment.
Nevertheless, it can affect your life. As well as the possible side effects of treatment, a diagnosis of prostate cancer can understandably make you feel anxious or depressed.
You may find it beneficial to talk about the condition with your family, friends, a GP and other people with prostate cancer.
Financial support is also available if prostate cancer reduces your ability to work.
How Often Should Men Have A Prostate Screening
According to Cancer Research UK, over 52,000 men are diagnosed with prostate cancer in the country each year, making it the most common cancer in men. Thats more than 140 cases a day. Among these cases, over 12,000 men succumb to illness and death.
Luckily, prostate cancer is treatable if caught early, with a survival rate of up to 90%. Partaking in annual or biannual prostate exams reduces the risk of late-stage prostate cancer and long-term urinary and sexual problems.
This article discusses everything you need to know about prostate screening. How often should men have a prostate screening? More importantly, at what age should men get screened for prostate cancer? Lets find out.
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Whats The Best Treatment For Prostate Symptoms
Treatments for prostate cancer include surgery to remove the prostate, radiation therapy, and ablation therapies, as well as active surveillance. Some treatments are better for some men and some prostates than others. There are side effects for each, so it really requires an informed discussion to help each man make an educated decision.
One thing we do at Yale is use an MRI of the prostate to evaluate the location of the prostate cancer for surgical planning. Ive found it to be quite helpful. Its not done everywhere.
When To Startand Stopscreening
The doctors and researchers who recommend screening argue that cases of prostate cancer found very early can be cured more quickly, with less chance of relapse or spread. Those who recommend against routine screening point to the slow-moving nature of prostate cancer and the side effects of surgical and medical treatment, which can be considerable.
The introduction of PSA screening in the US led to an initial increase in the number of prostate cancer cases diagnosed each year, even though many of these new cases were non-aggressive or low-risk prostate cancer. The issue was not that screening was harmful, it was that many of these low-risk cancers did not necessarily need immediate treatment. It seems strange to say that a patient might be better off leaving cancer untreated, but in some cases, it can be true. For a few years, the United States Preventative Services Task Force recommended against PSA screening. We are now seeing more cases of advanced prostate cancer diagnosed in recent years. This may be a long-tail effect of that USPSTF recommendation. It has now been changed to note that for men aged 55 to 69 years, the decision to undergo PSA screening is an individual one and should be discussed with your doctor. USPSTF continues to recommend against screening for men aged 70 and over.
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Preparing For A Prostate Exam
Theres nothing special that you need to do to prepare for a prostate exam. Tell your doctor if you have or hemorrhoids, as a DRE may aggravate these conditions.
If you decide to get a prostate cancer screening, your doctor will likely order a blood test, so inform the person drawing your blood if youre prone to dizziness.
Your doctor may ask you to sign a consent form before performing a cancer screening.
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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The Test Is Often Not Needed
Most men with high PSAs dont have prostate cancer. Their high PSAs might be due to:
- An enlarged prostate gland.
- Recent sexual activity.
- A recent, long bike ride.
Up to 25% of men with high PSAs may have prostate cancer, depending on age and PSA level. But most of these cancers do not cause problems. It is common for older men to have some cancer cells in their prostate glands. These cancers are usually slow to grow. They are not likely to spread beyond the prostate. They usually dont cause symptoms, or death.
Studies show that routine PSA tests of 1,000 men ages 55 to 69 prevent one prostate cancer death. But the PSA also has risks.
Should You Know Your Psa Level
Instead of a national screening programme, there is an informed choice programme, called prostate cancer risk management, for healthy men aged 50 or over who ask their GP about PSA testing. It aims to give men good information on the pros and cons of a PSA test.
If you’re aged 50 or over and decide to have your PSA levels tested after talking to a GP, they can arrange for it to be carried out free on the NHS.
If results show you have a raised level of PSA, the GP may suggest further tests.
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Craig Melvin And Al Roker Premiere Get Checked Psa
Dr. Matthew Rettig, the medical director of the Prostate Cancer Program at the Institute of Urologic Oncology at UCLA in California, said that even if screenings arenât performed right away, men should at least start talking about them with their doctors early in life.
âI think I would have that conversation fairly early on in life, maybe even in 30s or 40s, about when to initiate screening,â said Retting. âI think that would be most important for patients who are at high risk for prostate cancer and high risk for early onset of prostate cancer. Those are the types of patients that probably ought to have the discussion and make a decision about when to start screening at a relatively young age.â
Whats The Recommended Age For Your First Prostate Exam
Starting at age 50, all men should discuss getting a prostate exam with their doctor.
The reason for this is prostate cancer. In the UK, about one in eight men will be diagnosed with this in their lifetime. It mainly affects men aged 50 plus, but your risk increases as you get older, and the most common age to be diagnosed is between 65 and 69 years. Most men with early prostate cancer dont have any noticeable signs or symptoms.
The exception to this rule is if you are experiencing symptoms, or if your genetics predispose you as higher risk. Doctors are increasingly finding the tendency towards some prostate cancers can be inherited from your fathers family. Additionally, black men are at a higher risk, with one in four getting prostate cancer in their lifetime.
If youre experiencing no symptoms, heres the recommended age for prostate exam:
- If you have a family history, first prostate exam at age 40
- If you are black, first prostate exam at age 45
- If you have no family history and youre not black, first prostate exam at age 50
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Screening For Prostate Cancer
There is no national screening programme for prostate cancer in the UK. This is because there isnt a reliable test that can pick up prostate cancer that needs treatment at an early stage.
Overall research has shown that current tests dont reduce the number of men dying from prostate cancer. Research is going on to find a new test. Or see if the current test is more effective if used in a different way and can find the cancers that need treatment more accurately.
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Rettig said that someone who has a âstrong family historyâ of early onset prostate cancer might want to talk to their primary care provider or other health care practitioner earlier in life, while someone with less risk might prefer to wait.
The guidelines for how often men should be screened again also vary. If you have a high prostate-specific antigen , a protein made by cells in the prostate gland, you may be recommended to come back for more frequent screenings, but those with lower PSA levels might only be advised to come back every four years or so.
âIf youâre 55 and have you have a PSA of less than one, you can wait four years to get screened again,â Rettig explained. âAlternatively, if youâre 45 and have a PSA of two and a half, that might be someone who might get a biopsy or be re-screened within the year. ⦠How frequently one would be prescreened is really contingent upon the specifics of the patient.â
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This article was medically reviewed by Erik Kramer, DO, MPH. Dr. Erik Kramer is a Primary Care Physician at the University of Colorado, specializing in internal medicine, diabetes, and weight management. He received his Doctorate in Osteopathic Medicine from the Touro University Nevada College of Osteopathic Medicine in 2012. Dr. Kramer is a Diplomate of the American Board of Obesity Medicine and is board certified.There are 11 references cited in this article, which can be found at the bottom of the page. This article has been viewed 140,179 times.
The prostate is a walnut-sized organ in males that plays a major role in the production of semen. The easiest way to access the prostate is by way of an index finger carefully inserted into the rectum. The processes for accessing the prostate as part of a medical exam or for sexual pleasure are the same, and the same precautions should be taken. You should also keep an eye out for signs of potential prostate problems and contact your doctor as needed.
What Happens During A Dre Examination
The DRE requires the insertion of a gloved and lubricated finger into the rectum by a doctor to check the size of the prostate and confirm the presence or absence of any abnormalities. This test is important because it can uncover signs of prostate problems that may require further testing, which is why its usually the first test performed.
Men who have conditions like hemorrhoids are strongly advised to inform their doctor so that worsening of the condition by the test can be prevented.
The PSA blood test is the current recommended test for screening. Typically taking place after the DRE, the PSA test detects levels of the protein-specific antigen, made by the prostate, in the blood.
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Do Men Ejaculate During Prostate Exams
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He’s assured me it was perfectly normal to get an erection, and even ejaculate during the exam.I still wish he hadn’t tho….
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CRAPTAGON said:At the end of a general checkup a few years ago I was supposed to have my first prostate exam. My doctor, a very personable but large fingered man pulled out a syringe and test tube. Confused I asked what they were for. He said “Oh, that’s how we do prostate exams now. As a blood test. If there’s any issue, then we do it the other way.”I had been sweating up for the 20 years before that moment.
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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What Is Cancer Screening
Screening means testing people for early stages of a cancer, or for early changes that could develop into cancer if left untreated. For screening to be useful the tests:
- need to be reliable at picking up cancers that need treatment
- overall must do more good than harm to people taking part
- must be something that people are willing to do
Screening tests are not perfect and have some risks. The screening programme should also be good value for money for the NHS.
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American Cancer Society Recommendations For Prostate Cancer Early Detection
The American Cancer Society recommends that men have a chance to make an informed decision with their health care provider about whether to be screened for prostate cancer. The decision should be made after getting information about the uncertainties, risks, and potential benefits of prostate cancer screening. Men should not be screened unless they have received this information. The discussion about screening should take place at:
- Age 50 for men who are at average risk of prostate cancer and are expected to live at least 10 more years.
- Age 45 for men at high risk of developing prostate cancer. This includes African Americans and men who have a first-degree relative diagnosed with prostate cancer at an early age .
- Age 40 for men at even higher risk .
After this discussion, men who want to be screened should get the prostate-specific antigen blood test. The digital rectal exam may also be done as a part of screening.
If, after this discussion, a man is unable to decide if testing is right for him, the screening decision can be made by the health care provider, who should take into account the mans general health preferences and values.
If no prostate cancer is found as a result of screening, the time between future screenings depends on the results of the PSA blood test:
- Men who choose to be tested who have a PSA of less than 2.5 ng/mL may only need to be retested every 2 years.
- Screening should be done yearly for men whose PSA level is 2.5 ng/mL or higher.
Specialist Referral And Biopsy
Your doctor will discuss your prostate check results with you. If the PSA and DRC results suggest you have a high risk for prostate cancer, your doctor will refer you to a urologist .
The specialist will discuss having a prostate biopsy, in which a small sample of your prostate gland cells are taken for examination.
The aim of the biopsy is to confirm whether or not you have prostate cancer and, if so, whether it needs treatment. The treatment options will then be discussed with you.
If the biopsy shows no evidence of cancer, you may be advised to attend future check-ups.
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Great News For Guys: No More Invasive Prostate Exams
Good news for all the over-40 men out there: we don’t need routine screening for prostate cancer. More to the point, we don’t need to subject ourselves to the dreaded “digital rectal exam” that has been a standard procedure for decades. Most guys don’t need any encouragement to avoid this particular invasive procedure, but now there’s good scientific evidence saying we don’t 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, don’t 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.
Choosing Wisely, which was created by the American Board of Internal Medicine Foundation, is a great idea: a campaign to educate patients and physicians about what practices are: