Digital Rectal Examination For Prostate Cancer
A digital rectal examination , performed as part of an annual physical checkup, is one of the most important tests for the early detection of prostate cancer. Because the prostate gland is located just in front of the rectum, it cannot be felt from the outside of the body.
During the DRE, a doctor inserts a lubricated, gloved finger into the patient’s rectum to feel for lumps, enlargements, or areas of hardness that might indicate prostate cancer. The procedure lasts for less than minute and, while uncomfortable, should cause no pain. However, a painful examination could indicate the presence of other, benign conditions, such as prostatitis.
Do Men Ejaculate During Prostate Exams
ATM 3 CHAMPION OF THE WORLD.
Believe in Yourself and Aliens.
Hes assured me it was perfectly normal to get an erection, and even ejaculate during the exam.I still wish he hadnt tho.
ATM 3 CHAMPION OF THE WORLD.
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, thats how we do prostate exams now. As a blood test. If theres any issue, then we do it the other way.I had been sweating up for the 20 years before that moment.
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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Why Are Prostate Exams Performed
A lot of men do not realize the importance of a frequent prostate exam. When a man goes for a general check-up with his doctor, a prostate exam may be advised. This is considered part of a general health check-up.
It is generally advised that men undergo frequent health screenings once they reach the age of 40 . Research shows that this is the time when the risk of several prostate conditions increases.
For this reason, after 40, a man should ensure they obtain a prostate exam as part of their health screening.
The main reason why a doctor may advise on a prostate exam is to feel for any abnormalities with the mans prostate. This helps detect prostate disease. It is usually possible for a doctor to determine the health of the mans prostate through this examination. Further testing may be needed too.
The doctor can detect different prostate problems through a prostate exam. It is often considered the initial diagnostic option. The prostate exam itself can give a doctor an indication if there is an enlargement or swelling in the prostate gland. It also helps to determine prostate health.
In most cases, a prostate exam alone will not be the only diagnostic tool. After a digital rectal exam is done, the doctor will order additional tests if abnormalities are identified. This will help to diagnose problems like cancer and prostate enlargement.
Benefits And Risks Of Screenings
The benefit of any cancer screening test is to find cancer early, when it easier to treat. But the value of PSA screening for prostate cancer is debated. No single answer fits all men.
Prostate cancer often grows very slowly. PSA levels can begin to rise years before a cancer causes any symptoms or problems. It is also very common as men age. In many cases, the cancer will not cause any problems or shorten a man’s life span.
For these reasons, it is not clear if the benefits of routine screenings outweigh the risks or side effects of being treated for prostate cancer once it is found.
There are other factors to think about before having a PSA test:
- Anxiety. Elevated PSA levels does not always mean you have cancer. These results and the need for further testing can cause a lot of fear and anxiety, even if you do not have prostate cancer.
- Side effects from further testing. If your PSA test is higher than normal, you may need to have a one or more biopsies to find out for sure. A biopsy is safe, but can cause problems such as an infection, pain, fever, or blood in the semen or urine.
- Overtreatment. Many prostate cancers will not affect your normal life span. But since it is impossible to know for sure, most people want to get treatment. Cancer treatment can have serious side effects, including problems with erections and urinating. These side effects can cause more problems than the untreated cancer.
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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.
Two Main Screening Tests
There are two tests commonly used to screen for prostate cancer:
- The Digital Rectal Exam : A doctor or nurse inserts a gloved, lubricated finger into the rectum to estimate the size of the prostate and feel for lumps or other abnormalities.
- The Prostate Specific Antigen Test: This exam measures the level of PSA in the blood. The levels of PSA in the blood are often higher in men who have prostate cancer. The PSA level may also be high in other conditions that affect the prostate.Usually, the higher the bloods PSA level is, the more likely it is that a prostate problem is present. But other factors, such as age and race, also can raise PSA levels. PSA levels also can be impacted by certain medical procedures, some medications, an enlarged prostate or a prostate infection.Since your PSA level may be high for other reasons, your doctor will need to interpret the test results.
If the results of the PSA and/or DRE suggest that you might have prostate cancer, your doctor will need to do a prostate biopsy to find out. This means a sample of your prostate tissue will be removed with a needle and sent to a lab, where a specialist will determine if it contains cancer cells.
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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.
Imaging Tests For Prostate Cancer
Imaging tests use x-rays, magnetic fields, sound waves, or radioactive substances to create pictures of the inside of your body. One or more imaging tests might be used:
- To look for cancer in the prostate
- To help the doctor see the prostate during certain procedures
- To look for spread of prostate cancer to other parts of the body
Which tests you might need will depend on the situation. For example, a prostate biopsy is typically done with transrectal ultrasound and/or MRI to help guide the biopsy. If you are found to have prostate cancer, you might need imaging tests of other parts of your body to look for possible cancer spread.
The imaging tests used most often to look for prostate cancer spread include:
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This Kinda Gives New Meaning To The Doctor Is In
How are prostate exams performed? A doctor inserts a gloved, lubricated finger into your rectum to reach the prostate. Yup, you heard that right. A doctor sticks their finger up your butt. What do doctors feel for during a prostate exam? To check the walnut-sized gland, aka the prostate, for abnormal lumps or hard areas and screen for early signs of prostate cancer. This is a necessary medical procedure for guys at about age 50, usually done in addition to a PSA test, with 1 in 9 Canadian men developing prostate cancer during their lifetime.
Is It Time You Booked A Prostate Exam
Prostate checks are a part of life for most adult men. Its a necessary step to ensure that you stay on top of your health and become aware of any abnormalities before they evolve into serious problems.
For many men, it can be a nervous time. General Practitioner, Dr Sir-Kit Leong, from SmartClinics Clayfield in Brisbane has answered some of the most frequently asked questions by patients. Take a read and if youre still unsure, book an appointment with your GP for a chat before committing.
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Why Not Bring The Entire Staff Into The Exam Room For My Prostate Exam
But, if I cross the border into Georgia for the same exam, the exam room may be more crowded.
The Georgia Composite Medical Board recently proposed new rules defining Unprofessional Behavior. One new rule, if adopted and enforced, would redefine unprofessional conduct to include:
Conducting a physical exam of the breast and/or genitalia of a patient without a chaperone present.
This Rule would replace the existing Rule 360-3-.02 which currently reads:
Conducting a physical exam of the breast and/or genitalia of a patient of the opposite sex without a chaperone present.
The pre-existing rule was not perfect. If a patient does NOT want another person in the room, it should be their right to keep the traffic down even if the examining doctor is of the opposite sex. The old rule is silent on whether the chaperone needs to the same sex as the patient. So, read literally, a male doctor could bring in another male staff-member to comply with the pre-existing rule for say, a gynecologic exam.
Now for the potential consequences of the proposed rule.
My yearly prostate exam would fill the room with yet another individual. Im male. My internist is male. The proposed rule would add another body in the exam room. Might be male might be female.
Why not put in some bleachers?
Its not clear from the Boards minutes what these concerns were. But, my chest and my prostate can name a few.
Little Evidence Supports Digital Rectal Exams For Prostate Cancer Screening
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The quality of evidence to support the use of digital rectal exams for prostate cancer screenings in primary care setting was very low, according to a systematic review and meta-analysis recently published in the Annals of Family Medicine.
frequently incorporated as part of a routine primary care examination in men,Leen Naji, MD, of the department of family medicine at McMaster University in Hamilton, Canada and colleagues wrote. Some evidence suggests, however, that the may not significantly reduce mortality, but instead may result in a high number of false-positives leading to unnecessary invasive diagnostic tests that can precipitate pain, erectile dysfunction and urinary incontinence, as well as overdiagnosis and overtreatment of prostate cancer.
Naji and colleagues conducted a systematic review and meta-analysis to determine the diagnostic accuracy of digital rectal exams exclusively performed in the primary care setting. They identified seven studies that included 9,241 patients.
Naji and colleagues found that there was high heterogeneity across the studies, and digital rectal exams conducted by PCPs generally had poor performance. Also, pooled specificity was 0.59 , and pooled sensitivity was 0.51 . In addition, pooled negative predictive value was 0.64 and pooled positive predictive value was 0.41 .
Annals of Family Medicine.
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How A Doctor Performs A Prostate Exam
The male reproductive system relies on a healthy prostate to function. The prostate is a relatively small gland. It is the size of a chestnut . The prostate produces a fluid that combines with sperm.
The prostate fluid helps to nourish sperm. In turn, reproduction is possible, and semen can survive in the acidic environment of the vagina.
There are times when a prostate may give a man problems. Several complications have been linked to the prostate gland. Benign prostatic hyperplasia is generally considered the most common type of prostate condition.
Other common issues that men are concerned about include prostate cancer and prostatitis.
Prostate screening is one of the first diagnostic tools used to detect these problems.
While men generally find this to be an uncomfortable procedure, its benefits need to be considered.
We take a look at how a prostate exam is done. The post also considers why a prostate exam is done.
Do Doctors Still Do Prostate Exams
· Dr. Miller: Well, aside from the prostate exam being the brunt of many, many jokes over the year, the answer now is generally no. The guidelines no longer suggest doing a prostate exam to screen for colon cancer. It was done in the past because the number of prostate cancers were picked up on digital screening, but weve no evidence that finding those cancers on exam actually leads to better outcomes, that is cures for prostate cancer. We do
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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.
How Often Do I Need A Prostate Exam
Prostate cancer is one of the most common types of cancer in men, and its also highly treatable if caught early. There are a number of treatment options that have proven to be successful in combatting prostate cancer, even in its advanced stage.
Early detection is crucial because it gives you more treatment options and a better chance of eliminating cancer. The prostate-specific antigen test is used to check the PSA levels in your blood, and these levels are different for every man the indicator is whether the number is going up as compared to your prior PSA exam result. If your PSA is high the first time you have the test, your doctor may ask you to have a biopsy.
Similarly, your doctor will perform a digital rectal exam during your annual checkup to feel for any lumps or enlargement of your prostate. Lets talk about how often you might need to have a prostate exam and what you can expect.
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How To Find A Gp
If you dont have a GP, you can find a doctors surgery in your local area by going to:
To make an appointment to see your GP you:
- can telephone your GP practice
- book an appointment online through your GP practice website
- may be able to use the NHS App
Try different times of the day if it’s difficult to get through by phone. It could be particularly busy at the beginning of the day. You dont have to tell the receptionist what you want to see the doctor for, although sometimes it might help to explain your situation.
You might be able to go in person to book an appointment at some GP practices. But at the moment most practices do not provide this service. It may help to see if your GP practice has a website, this will explain the best way to get an appointment.
The receptionist at your GPs practice may offer you a telephone or video appointment first. Your GP will ask you to make another appointment if they need to see you again. You may be asked to attend in person, especially if they need to examine you. The receptionist will give you a date and time for this.
Accept a booked appointment, even if you think its a long time to wait. You could ask about cancellations if you are able to get to the practice at short notice. Do check that they have the right contact details for you, including your telephone number and email.