Everything you need to know about how a prostate exam is done, what doctors look for and why you should get one.
A prostate exam is one of the most dreaded events for men. While a prostate exam will never be something to look forward to, the reality is that it only takes a couple minutes and it’s typically painless.
It can also save your life.
This guide will help you understand more about prostate exams, what to expect and why it’s so important for men over 50.
What is a Prostate Exam?
The prostate is a walnut-sized gland near the bladder that aids in the production of seminal fluid. A prostate exam is a simple test that helps your physician detect whether your prostate is inflamed or enlarged. This exam, also known as a digital rectal exam (DRE), is usually performed as part of a routine exam or if you start to have difficulty urinating. It’s also an important diagnostic tool in detecting prostate cancer, the second-most common type of cancer in men.
Every year, there are nearly 180,000 new cases of prostate cancer in the U.S., according to the American Cancer Society. The disease kills nearly 26,000 men every year. The good news is prostate cancer is fairly easy to treat when detected early. Some prostate cancers grow so slowly that treatment is not necessary.
How a Prostate Exam is Performed
During a DRE, your doctor will ask you to bend at the waist while standing with your feet apart or lay on your side with your knees in toward your chest. In order to make the exam as painless as possible, focus on breathing normally and relaxing your body.
Your physician will gently insert a lubricated, gloved finger into your rectum. One hand will feel your pelvic area while the other presses on your prostate. You will be aware of movement of the doctor’s finger, which he will move in a circular motion to identify the groove and lobes of the gland.
This exam may cause momentary discomfort, but it’s usually minimal. You may also feel the need to urinate during the exam, especially if you have an enlarged prostate.
This exam has no risks and your doctor will be able to detect whether your prostate seems to have a normal shape and size in a matter of a minute.
Preparing for the DRE
There’s not much you need to do to prepare for the exam, although it’s important to inform your doctor if you have anal tears, hemorrhoids or any other health issues with your anus. You should also tell your doctor if you take any supplements or medications.
What is a PSA Test?
The prostate exam is only one part of prostate cancer screening; the other part is a test for prostate-specific antigen (PSA) levels. PSA is a protein that aids in liquefying semen. It’s normal to have some PSA in your bloodstream, but there are a few things that can cause high levels of PSA in the blood: an infected or inflamed prostate, an enlarged prostate or certain types of prostate cancer. Some types of prostate cancer can actually lower PSA levels.
The PSA test is not perfect and can lead to false negatives or false positives. Your doctor will discuss the benefits and limitations of the test with you. Along with looking at the amount of PSA in your blood, your doctor will also monitor how fast the number changes. Many factors can influence PSA levels and an abnormal PSA test result (whether it is high or low) does not necessarily mean you have cancer. In fact, most men with an elevated PSA level do not have prostate cancer. Men can also have prostate cancer with normal PSA test and prostate exam results as well. An abnormal test may require further testing, however, with repeated testing or other diagnostic tests.
Are There Other Tests for Screening Prostate Cancer?
If you have an abnormal PSA test and/or DRE, your doctor may recommend additional diagnostic tests. One option is a transrectal ultrasound, which involves inserting a small ultrasound probe into the rectum to visualize the gland. A biopsy may also be used to rule out or confirm prostate cancer. This test requires inserting a needle into the prostate to remove tissue samples for examination under a microscope.
Can I Do A Self Prostate Exam?
There are some self exams that are easy and effective, including a self testicular exam. Unfortunately, a self exam of the prostate is very difficult from a mechanical standpoint. Most men cannot reach farther than the base of their prostate. Even if you could, it’s unlikely you would know what you are feeling. A digital rectal exam is best performed by a knowledgeable urologist who understands what to feel for and what indicates a problem.
How Often Do Men Need a Prostate Exam?
The American Cancer Society currently recommends men get prostate cancer screening (including a DRE and PSA test) every year starting at the age of 50. Men with a higher risk of prostate cancer should begin prostate cancer screenings at 40 or 45. Men with a higher than average risk include African-American men as well as men with a son, father or brother who have been diagnosed with prostate cancer before the age of 65.
The DRE and PSA blood test are important tools for screening for prostate cancer. If you are over the age of 40 and have never had a prostate exam, it’s important to talk to a skilled urologist about your specific risk factors for prostate cancer and overall prostate health. While you may find the test embarrassing or uncomfortable, it’s worth those few minutes to give you peace of mind and keep your prostate health in check.
Contact the Alarcon Urology Center to schedule a prostate screening today.