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.
Deciding If You Need A Prostate Screening
What Do You Want Men To Know About Prostate Cancer
The important thing to know is that, if you live long enough, you will probably get prostate cancer. If you live into your 80s, about 80 percent of men have some sort of prostate cancer. That doesnt mean theyre going to die from prostate cancer because, as a percentage, very few men die from prostate cancer. It means its important to be aware of it and consider screening early, so if its a high-grade type, we can identify it and treat it.
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So Should All Men Get A Prostate Exam Screening
At this point, its actually recommended that each individual talks with his doctor to assess the pros and cons of prostate exam screening. In an ideal world, everyone would get screened and diagnosed correctly, though the data bears out this isnt always the case. Overdiagnoses appear to be a major issue, along with the actual effectiveness of prostate exams themselves.
It certainly can help with early detection in order to start treating prostate cancer sooner rather than later, and its always a good idea to have regular physical exams with a medical professional. However, there are other ways you can ensure your prostate health remains in top working order.
For instance, you can help decrease your risk for prostate cancer and improve prostate health through diet and lifestyle changes. Consume tomatoes, wild-caught fish, green tea and pumpkin seeds avoid overconsuming meat and dairy, and exercise.
Causes Of Prostate Cancer
The causes of prostate cancer are largely unknown. But certain things can increase your risk of developing the condition.
The chances of developing prostate cancer increase as you get older. Most cases develop in men aged 50 or older.
For reasons not yet understood, prostate cancer is more common in black men and less common in Asian men.
Men whose father or brother were affected by prostate cancer are at slightly increased risk themselves.
Recent research also suggests that obesity increases the risk of prostate cancer.
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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.
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.
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What Do You Say To Patients Diagnosed With Prostate Cancer
Something I say to my patients a lot is that, in treating prostate cancer, we end up trying to extend your quantity of life at the cost of your quality of life. And so, at some point, if the quantity is extended a lot, and we can minimize the effect on quality, that makes sense, but the equation is different for every man. How much decrease in quality of life are you willing to accept if were going to extend your life?
Realistically, a lot of guys who are 70 dont have any sexual function anyway, so thats not a huge loss for them. As men get older theres definitely an increased chance of having erectile dysfunction the guys who have sexual function over 70 are very keen on preserving it. Even for the guys who dont have good sexual function, who are on Viagra, for them its often even more important to preserve what sexual function they have.
Who Should Get Screened For Prostate Cancer
Prostate cancer typically starts in men around 55 to 70 years old. For men who are not at a higher risk of developing the disease should begin a conversation with their doctor about getting screened in their fifties and repeat the screening about every two years.
Men who are at higher risk for developing prostate cancer should begin screenings at age 40. Those at higher risk for prostate cancer include:
- Black or African-American men
- Men with a family history of prostate cancer
- Men who have been diagnosed with prostate cancer before
- Men who have a family history of colon, breast, ovarian, or pancreatic cancer
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Understanding Your Psa Test Results
PSA is usually measured in nanograms per millilitre of blood . There is no one PSA value that is considered normal. The value varies from man to man and increases as you get older. Most men have a PSA level of less than 3ng/ml.
Your GP or specialist may suggest further tests if your PSA level is higher than would be expected for someone of your age. Talk to your doctor about your PSA level and what this means for you.
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.
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What To Do If You Are Worried About Prostate Cancer
Talk to your GP if you’re worried about prostate cancer. Or if you have urinary symptoms such as difficulty passing urine. The symptoms don’t mean that you have prostate cancer, but it is important to get them checked.
Adult screening programme Prostate cancerUK National Screening Committee, Last accessed March 20222
Screening for prostate cancer. External review against programme appraisal criteria for the UK National Screening CommitteeUK National Screening Committee, October 2020
Prostate cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow upC Parker and others
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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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.
What Happens During A Prostate Exam
Prostate exams might be uncomfortable. Here is what to expect when you receive your first prostate exam. Prostate exams can include two major tests: the PSA blood test and a digital rectal exam .
PSA Blood Test
The PSA test measures the amount of prostate-specific antigen in your blood. PSA is a protein that is produced by your prostate. Normally, your prostate produces only small amounts of PSA. However, if you have prostate cancer or diseases such as benign prostate hyperplasia , your prostate might release more amount of PSA. As such, high levels of PSA can indicate disease.
Digital Rectal Exam
The DRE exam is used to physically examine the size, shape, and texture of your prostate. In order to examine your prostate, your doctor will insert a lubricated, gloved, finger into your rectum to inspect your prostate. This exam should not be painful and will only last 1-2 minutes. Your doctor will be feeling for hard, lumpy, or other abnormalities of the prostate. Although slightly uncomfortable, this test can be extremely helpful for detecting prostate cancer at an early age.
During the exam, you will be asked to remove your clothing and put on a hospital gown. There are a number of possible positions to stay in but will completely depend on your physician and your own preference. For instance, you can lie on your side, bend over the table, or squat on the exam table. These options will be disclosed to you by your doctor.
How to Prepare for a Prostate Exam
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This examination lasts 15 to 20 seconds, according to Ehdaie, and is uncomfortable but not painful. Rettig noted that on its own, the digital exam is not going to add very much, but can be paired with the blood test to give a full picture of the patients health situation.
After that exam is completed and the bloodwork is done, the results are evaluated together.
A decision would be made to either pursue further tests because the screenings suggest there may be something that would be of concern, or they would return at the next scheduled , Ehdaie said.
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.
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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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Heading In The Wrong Direction
Since the U.S. Preventive Task Force recommended against the blood test portion of the prostate cancer screening process in the mid-2000s, Dr. Harris has seen the gains made in catching prostate cancer early revert to the days before regular screening became the norm.
Between 1992 and 2012, there was a greater than 50 percent reduction in the death rate from prostate cancer in the U.S., thanks to the addition of blood test to the screening process and more aggressive and effective treatments for younger men.
The recommendation against screening has hurt American men, Dr. Harris said.
The average tumor size Dr. Harris was removing in the 90s was 12 grams. By the mid-2000s, the average was down to 3 grams, which means he was removing cancers early, before they could spread or cause more harm.
Since 2008, however, the average cancer size has risen to more than 10 grams, almost back to the pre-screening era. The percent of patients whose cancer has spread beyond the prostate is at least 40 percent right now. Those men have a higher risk of cancer recurrence, too.
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Living With Prostate Cancer
As prostate cancer usually progresses very slowly, you can live for decades without symptoms or needing treatment.
You may find it beneficial to talk about the condition with your family, friends, a family doctor and other men with prostate cancer.
Financial support is also available if prostate cancer reduces your ability to work.
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.
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