What Are The Symptoms Of Prostate Cancer
Not everyone with prostate cancer has symptoms, so regular screening should be a part of your annual physical, starting at the age of 40-50. However, prostate symptoms should never be ignored and should be brought up to a physician.
Typical symptoms of prostate cancer, according to the Prostate Conditions Education Council , include:
- Frequent urination
- Weak urinary stream
- Pain or burning during urination
- Blood in the urine or ejaculate
- Bone pain in the hips, ribs or back
- Back pain
Read our guide to common pee problems that may be signs of prostate cancer if you are experiencing urination problems.
Deciding If You Need A Prostate Screening
Why Is Active Surveillancethe Wait
We utilize active surveillance for men who have been diagnosed with a low-grade prostate cancer. The reason we monitor low-grade prostate cancer using active surveillance, rather than treating it aggressively, is that there are cancers that dont need treatment.
With low-grade prostate cancer, youre more likely to have problems from the treatment than from the prostate cancer. Any treatment we do for prostate cancer is going to affect a mans urinary and sexual function. It may affect it a little bitor a lot. With this type of prostate cancer, we can tell you now that theres very little likelihood the cancer is going to cause you any problems. We have a good and growing amount of evidence that low-grade prostate cancers, on average, progress very slowly and do not appear to spread to the lymph nodes. Active surveillance lets us detect higher grade disease and treat it at that point.
For us to do anything and treat it is going to change your quality of life. I think thats a powerful thing.
Recommended Reading: Preparation For Prostate Mri Scan
Who Should Get A Prostate Exam
Starting at age 50, all men should discuss prostate cancer screening with their doctor. The American Cancer Society advises men at higher risk to have this conversation at age 45.
Youre considered to have an increased risk if youre African-American or if a first-degree relative had prostate cancer before age 65. If more than one first-degree relative had prostate cancer before age 65, you might want to consider beginning prostate cancer screening even earlier.
The ACS estimates there will be about 180,890 new cases of prostate cancer in the United States in 2016. About 26,120 men will die from it.
Prostate cancer is easier to treat before it spreads. However, some prostate cancers are so slow-growing that they dont always require treatment. A lot depends on your age and other factors.
Discuss your risk factors with your doctor, and ask if you should have a prostate exam as part of your yearly checkup.
What Will I Know Afterwards
A rectal exam can’t definitively diagnose prostate cancer. Only a biopsy can do that and you wont be offered one if you don’t need it. Rectal exams are part of a suite of diagnostic tests, including PSA blood tests and MRI scans, that help to either build or break the case for further investigation.
Recommended Reading: Brca Gene And Prostate Cancer
What Age Should You Have A Prostate Exam
The term “prostate exam” generally refers to a digital rectal exam , which may be done in combination with a PSA test during cancer screenings or independently as a routine prostate health check. The DRE is a physical examination, done by your doctor, of the prostate gland. To perform this exam, your doctor will insert a gloved and lubricated finger into the rectum to feel for any changes or abnormalities in the prostate gland including enlargement, bumps, hard areas or texture changes that may indicate prostate conditions and/or prostate cancer.
Active surveillance of hormone irregularities is key to preventing prostate cancer. Testing follow-up may be necessary for certain results. Men of any age who have noticed any of the prostate-related symptoms listed above should see their doctor for a prostate exam immediately. Routine annual prostate exams, as part of standard preventive care, are recommended for all men 40 years of age or above, as risk of developing most prostate conditions begins to rise in men of this age group.
For information on current clinical trials associated with prostate cancer and treatment options visit the American Cancer Society.
How Do I Screen For Prostate Cancer
There are two main early stage screening methods a digital rectal exam , and a blood test measuring PSA levels. PSA screening is regarded as the best method to screen for prostate cancer in men over 40 or those of a certain risk factor.
While men might be intimidated by a DRE, itâs a quick and safe screening technique used by a physician, and should cause no significant pain.
A Digital Rectal Exam is a simple, painless and quick procedure. A physician inserts a gloved and lubricated finger into the rectum and feels the prostate to identify if the prostate is enlarged, has lumps or is an abnormal texture compared to a healthy example.
Although this procedure is a very clear indicator of prostate health, the entire prostate canât be examined during a DRE. This is why physicians will also take into account PSA blood work, health history, and other risk factors. Overall, itâs often difficult to detect prostate cancer early, itâs mostly found through PSA testing – so PSA screenings should be done regularly, starting at the age of 40-50.
Read Also: Cryoablation Success Rate For Prostate Cancer
How Do You Diagnose Prostate Cancer
Prostate cancer is often first detected through prostate screening. The standard screening test is a blood test called a Prostate-Specific Antigen test. This test measures levels of PSA in the blood stream, a protein produced by the prostate gland. There are two types of prostate-specific antigens: 1) bound PSA, which circulate through the blood stream bound to other proteins, and 2) free PSA, which travel alone through the blood stream.
A PSA test measures the total of both free and bound PSA, while a free-PSA test measures the percentage of unbound PSA only.
High levels of PSA are often found in men who have developed prostate cancer. However, a high PSA level does not always mean cancer. Other conditions and factors that can increase PSA levels, include:
Enlarged prostate This condition, also called benign prostatic hyperplasia , is a non-cancerous enlargement of the gland. It is very common among men as they reach middle age and beyond, and often causes PSA levels to rise.
Prostatitis This is infection or inflammation of the prostate gland, which can cause an increase in PSA.
Medications Men who are prescribed male hormones, such as testosterone, or medications that increase testosterone levels may have elevated PSA levels triggered by these medications.
Aging PSA levels rise gradually as men grow older, even when no prostatitis, cancer or other prostate issues are present.
Self Prostate Exam For Prostatic Hyperplasia
Clinically we divided prostatic hyperplasia into three gradients, indicating the severity of benign prostatic hyperplasia disease. So, in our daily lives, how to perform self prostate exam? What are the evaluation criteria?
According to the severity of the disease, each disease can be divided into mild, moderate and severe, benign prostatic hyperplasia is with no exception. So what are the typical symptoms for mild, moderate and severe prostatic hyperplasia? How can we male patients to perform self prostate exam?
What Happens After The Dre
If any abnormalities are found during the DRE, the doctor may order more tests and possibly schedule a prostate biopsy to see if there are any signs of cancer present.
If there are no signs of prostate cancer found during screening, the results of the PSA blood test may help to determine the time between future prostate cancer screenings. PSA levels vary by age and other factors.
Ultimately, you and your doctor will decide how often you should be screened since your diet, health and lifestyle habits are all factors on the timing and frequency of your prostate cancer screenings. Be sure to consult with your doctor if you notice any changes in your health.
What Happens During A Dre
The DRE will take place in a private exam room at your doctor’s office. The test only takes a few minutes. You will need to take off any clothes below your waist. You will be given a gown to wear or a cloth to wrap around your body.
For men. The doctor will ask you to stand and bend forward at the waist or they will ask you to lie on your side on an exam table with knees pulled up to your chest. As they start the DRE, the doctor may ask you to relax and take a deep breath. Then they will gently insert a lubricated, gloved finger into your rectum. The doctor will feel the size of your prostate gland. They will also feel for bumps, soft or hard spots, or other abnormal areas. The doctor will also examine the wall of your lower colon and rectum.
For women. The doctor will usually ask you to lie on your back on an exam table. Your feet will be in raised stirrups. The doctor may ask you to relax and take a deep breath as they start the DRE. Then they will gently insert a lubricated, gloved finger into your rectum. The goal is to feel your reproductive organs and the bowel. The doctor may also feel for problems in your internal organs. They do this by pressing on your lower abdomen or pelvic area with their other hand.
A DRE usually does not hurt, but you may be uncomfortable. You may also feel the need to urinate. If a man’s prostate is enlarged, there may be some discomfort or mild pain during the exam.
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.”
Do All Men Who Are Treated For Prostate Cancer Lose Sexual And Urinary Function
Its definitely not true that all men are incontinent and impotent after treatment for prostate cancer. Urinary incontinence is usually temporary.
There can be a sexual impact for guys who have normal function. If the cancer is near their nerve bundle, theyre going to have a decrease in sexual function. If its not, and we can do bilateral nerve sparing surgery, studies show 70 percent can get back their normal sexual function. It all depends on where the cancer is. But the truth is that we cant predict very well who will be the 30 percent who will haveor still haveED some already do have ED because of age, diabetes, hypertension or renal failure.
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.
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 that in addition to the PSA and subsequent DRE and Biopsy that can give a doctor more information on 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.
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 prostate biopsy is sometimes done. This helps to provide a more accurate test for cancer. A colonoscopy is sometimes needed too. This is especially the case when prostatic carcinoma is suspected.
How Is A Digital Rectal Exam Performed
A DRE is a physical exam of the prostate. The health care provider will ask the patient to bend over a table or lie on his side while holding his knees close to his chest. The health care provider slides a gloved, lubricated finger into the rectum and feels the part of the prostate that lies next to it. The DRE may be slightly uncomfortable, but it is brief. This exam reveals whether the prostate has any abnormalities that require more testing. If an infection is suspected, the health care provider might massage the prostate during the DRE to obtain fluid to examine with a microscope. This exam is usually done first. Many health care providers perform a DRE as part of a routine physical exam for men age 50 or older, some even at age 40, whether or not the man has urinary problems.
Self Prostate Exam: Hot Water With Hip Bath For 5 Days
How to avoid the detour on the diagnosis of the disease? Experts recommend a simple self prostate exam which is:
If you find yourself may have at least one of the above three types of symptoms, patients can use hip bath with hot water daily for 1-2 times, each time 20 minutes. The water temperature should always remain at 50 Celsius degrees, and receive the treatment continuously for 5 days. If the symptoms reduce or disappear, the patient is likely to be suffering from chronic prostatitis. This self prostate exam is simple with no toxic side effects and helpful for the diagnosis and treatment.
What Are Clinical Trials And Are They Right For You
Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for you.