- What is a prostate exam?
- Types of prostate exams
- Our natural & non-invasive prostate biopsy alternative
- What kind of doctor do you see for a prostate exam?
- What do doctors check for in a prostate exam?
- What happens in a prostate exam?
- How to prepare for a prostate exam
- When should I start getting prostate exams?
- How often should a man get his prostate checked?
- What happens after a prostate exam?
- How do you check your own prostate?
Prostate cancer is the most common type of cancer in men.
The disease is prevalent in men over 50, and even if you’re not diagnosed with prostate cancer, this is the only gland in the body that continues to grow throughout life.
This means that the prostate can grow enormous before it becomes a problem.
Men who do not have prostate cancer are likely to get benign prostatic hyperplasia (BPH) at some point in their lives.
Prostate cancer and BPH can be severe illness that causes pain, impotence, and urinary problems.
These symptoms may not be noticeable until the problem is severe.
If caught early, these diseases can be cured. If you are diagnosed with prostate cancer at an early stage, you have a better chance of survival than if you had lung cancer.
But many men don’t know they have prostate cancer until they have complications. That’s why doctors screen apparently healthy patients for prostate conditions.
So, how often should a man get his prostate checked? And what types of prostate exams can detect prostate problems? Keep reading to find out.
What is a prostate exam?
A prostate exam is a medical test or maneuver used for prostate-related conditions. These exams are essential as a part of screening for prostate cancer. However, in searching for prostate cancer, doctors commonly find many cases of prostate enlargement.
When the doctor examines your prostate, they can use different methods. It depends on your signs and symptoms, age, and other factors.
Sometimes they would only perform a physical exam. In other cases, they will order a blood test or an ultrasound. And if your healthcare provider is actively suspecting prostate cancer, they may recommend a prostate biopsy.
Types of prostate exams
Prostate cancer can be detected early by a blood test called PSA (prostate-specific antigen), a digital rectal exam, or an ultrasound scan. Sometimes your doctor may recommend a prostate biopsy.
Here’s the overview of each one (1,2,3):
A PSA test measures the protein level in the bloodstream produced by cells in the prostate gland. The protein is known as PSA or prostate-specific antigen, and it is only produced by the prostate.
The higher the PSA level, the greater the chance that the cells in the prostate gland are growing. However, doctors can only guess if such growth is due to benign prostatic hyperplasia or prostate cancer.
The PSA screening can detect prostate cancer before it causes any symptoms. It is simple, inexpensive, and effective but isn’t very accurate.
The PSA level may be elevated for many reasons, including inflammation, infection, or injury to the prostate. Thus, it may give false positives, and the doctor should perform other tests, such as a digital rectal examination, for confirmation.
Digital rectal examination (DRE)
A digital rectal exam is a part of the physical exam in a urologist’s office. This prostate exam provides valuable insight into the rectum and a man’s prostate gland to check for any lumps, swelling, or prostate tumors.
A digital prostate exam involves inserting two fingers into the rectum to check the prostate. This test is recommended for men with symptoms of prostate disease, a family history of prostate cancer, or a high risk of having these problems.
After a PSA test and a digital rectal examination are done, doctors will have a suspicion about your prostate health. If your risk of prostate cancer is high, you will be referred to a urologist, for instance, if your PSA level is higher than 5.0 ng/ml.
Your doctor may recommend a prostate biopsy when you have an increased risk or a suspicion of prostate cancer.
A prostate biopsy involves taking a sample of tissue from the prostate gland. This sample can then be examined under a microscope to see if cancer cells are present.
Although a prostate biopsy is one of the most common procedures for detecting prostate cancer, it has many potential side effects, risks, and complications.
This includes bleeding, pain, infection, acute urinary retention, and sexual problems.
Prostate ultrasound scan
In some cases, your doctor will need extra information about the prostate tissue, but the risk or the suspicion is not worrying enough to warrant a prostate biopsy.
That’s when a prostate ultrasound scan is used to obtain more information.
These exams can be performed through the abdomen with a full bladder or a transrectal ultrasound, with a probe inserted in the rectal cavity to reach the prostate. The former is more comfortable and easier to perform, but the latter is much more accurate.
Our natural & non-invasive prostate biopsy alternative
In our opinion, a far safer and gentler prostate biopsy alternative is our Advanced Prostate Cancer Risk Assessment (APCRA). This consists of non-invasive blood tests and specialized color Doppler scans.
The variety and sophistication of some of these new blood tests make this a very realistic alternative to a prostate biopsy, especially if you have a preference for non-invasive diagnostics and treatments.
After this testing, you will receive a thorough, 3-hour consultation from a Naturopathic Physician who is also a Professor of Urology and a very detailed, written report of your results to be discussed during the appointment.
He will walk you through the results of his assessment and explain every aspect and each option available to you, while also answering any questions that you may have. Your consultation will be like an educational mini-seminar about the real issues facing you as a patient.
Most urologists will have a preference for the particular treatment that they provide. However, the consultant you will see has no agenda and is completely free to offer honest, independent advice.
He will try and help with any information you need in order to arrive at your decision. But he will not try to sway you one way or the other.
Aside from that, the greatest additional benefits of the APCRA are that it is non-invasive, does no damage, and does not close off any avenues for future treatment.
What kind of doctor do you see for a prostate exam?
Prostate exams are performed by a urologist, an internal medicine doctor, a family doctor, or a general practitioner. They are all qualified to order a prostate screening test, but not all of them will be qualified to treat your condition if they find abnormalities. In such a case, they will refer you to a urologist.
Urologists specialize in diagnosing and treating problems associated with the urinary system. They also treat diseases of the bladder, kidney, and other parts of the urinary tract.
So, why are they the specialist you want to see for a prostate-related problem? That’s because they also specialize in the male genitals and accessory organs, which are part of the urinary system.
What do doctors check for in a prostate exam?
In a prostate exam, doctors will routinely check for the PSA level and different physical traits of the prostate gland (1,2,3):
The prostate gland grows as we age, producing more PSA protein as it continues growing. Thus, PSA levels will naturally increase, even if you don’t have problems with your prostate.
But such an increase warrants attention after a threshold of 5 ng/ml. The threshold will be lower if you are 40 to 60 years, and there’s a PSA levels chart and other elements to consider.
Physical traits of the prostate gland
Doctors will also check different aspects of the prostate through the digital rectal exam.
For example, lumps or growths are noticeable if they are located in the posterior aspect of the prostate.
Doctors may also feel a change in the consistency of the prostate. It feels hard and lumpy in case of prostate cancer.
A skilled doctor may even detect BPH by simply touching the prostate gland in a digital rectal exam.
Ultrasound characteristics of the prostate
During an ultrasound scan, doctors will check how the ultrasound waves go through the prostate. When the prostate has lumps and is harder than usual, the ultrasound shows shadows and images that suggest the presence of prostate cancer.
An ultrasound will also come in handy to measure the gland’s volume, which is a sign of the severity of benign prostatic hyperplasia.
What happens in a prostate exam?
There are three main routine prostate exams. They are the PSA test, the digital rectal examination, and the ultrasound of the prostate. Each has different features we can discuss:
A PSA test feels like any other blood test you have previously taken. It is simply drawing blood from your veins, analyzing the sample, and receiving the results after a few hours or one day, depending on the laboratory.
Digital rectal exam
A digital rectal examination involves inserting two fingers into your rectum. The doctor will glove and lubricate their fingers and ask you to adopt a fetal position on the examination table. The exam shouldn’t take more than two minutes and is usually uncomfortable but not painful.
A prostate ultrasound can be done through your abdominal cavity or with a transrectal probe. Abdominal ultrasounds are easy to do and will only require that you come to the sonographer’s office with a full bladder.
You will feel the probe on your abdomen for a little while as the doctor measures and examines your prostate. Then you will be asked to empty your urinary bladder and repeat the same measures.
A transrectal prostate ultrasound is similar to a digital rectal examination, except that a probe will be inserted in the rectal cavity instead of two fingers. It will also be covered with a plastic wrapping and lubricated with gel.
How to prepare for a prostate exam
Before taking a prostate exam, you should know that each one has different recommendations.
Depending on the variant, you may need to keep in mind a few things:
- PSA test results can be altered by urinary or prostate infections, recent trauma, or having sex before drawing the blood sample. Ask your doctor how much time you need to wait before doing your PSA exam if you went through one of these events.
- You don’t need much preparation for a digital rectal exam. Just be sure to shower or a bath before going to the doctor’s appointment. The exam might not be as uncomfortable when your rectum is empty. You could eat more fiber-rich foods for a few days to stimulate intestinal transit.
- An ultrasound scan requires you to come to your appointment with a full bladder if you get an abdominal ultrasound scan. If you’re receiving a transrectal ultrasound, you could perform a rectal enema the same morning to reduce discomfort.
When should I start getting prostate exams?
The American Cancer Society recommends that men should not receive prostate cancer screening exams without discussing it with their doctor.
So, even if you are 50 years, you should talk about it with your doctor first to make your informed screening decision. That’s because prostate exams are not entirely reliable, and you need to know the pros and cons before starting the process.
Depending on your risk, your doctor may recommend a different age to start checking your prostate (1):
- Men with average prostate cancer risk may have their first prostate exam after 50 years.
- If your prostate cancer risk is high, you may need to start prostate screenings after 45 years.
- Those with a very high risk will be recommended a PSA screening age of 40 years.
- If you have prostate cancer symptoms, your doctor may recommend screening for prostate cancer regardless of your age.
How do you know that your risk of prostate cancer is high? This group includes African American men with a first-degree relative diagnosed with prostate cancer before 65 years. Your risk is very high if you have two or more first-degree relatives with a prostate cancer diagnosis before age 65 years.
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How often should a man get his prostate checked?
The answer to this question depends on your PSA levels (1).
- If your PSA levels are lower than 2.5 ng/dl, you don’t need to get tested frequently. You will be fine receiving new prostate checks every two years.
- If you have 2.5 ng/dl or more in your PSA results, the recommendation will be retested every year.
What happens after a prostate exam?
After your prostate exam, the doctor will evaluate the results and act accordingly. As noted above, the PSA guideline depends on your age, risk factors, and the results you get.
If you don’t have alarming results, you will probably not need further tests. Your doctor may recommend a prostate biopsy if you have high PSA levels or suspicious lumps in the DRE or ultrasound scan.
If you’re diagnosed with prostate cancer or benign prostatic hyperplasia, the urologist will give you various treatment options according to your condition, age, and other factors.
How do you check your own prostate?
As mentioned above, there are specific PSA screening guidelines. PSA tests and other medical screening methods should only be performed after talking about it with your doctor. There are many false positives, and doctors deal with them by selecting patients for screening according to their risk.
Self-examination of the prostate is not recommended because it requires medical training to interpret the results and avoid the risk of overdiagnosis.
So, how do you check your own prostate? You should be aware of the signs and symptoms of prostate disease and report them to your doctor as soon as possible.
Alarm signs of prostate problems include (1,2):
- Difficulty urinating
- Frequent urination at night
- Painful urination
- Slow urinary stream
- Dribbling after urinating
In this article, we went through the most important prostate gland screening procedures, including the PSA test, digital rectal examination, and ultrasound scan. Each one has its recommendations according to the risk factors of each patient.
The age for a man to get his prostate checked for the first time depends on such risk factors, but it’s usually around 40 to 50 years. Prostate exam guidelines are very specific and are made to reduce the risk of unnecessary procedures with adverse events.
You don’t want to undergo a prostate biopsy if you don’t need it, especially if you’re left with bleeding and other side effects you could have spared. That’s why we recommend talking to your doctor about your screening recommendations before running a PSA test or any other screening method.