Prostate Screening

Did you know that prostate cancer is the second leading cause of death in males, only behind lung cancer? The American Cancer Society states that one in seven men will be diagnosed with prostate cancer in their lifetime. Such an eye-opening statistic, and one that can be controlled with prostate screenings and exams. Many males avoid this entire topic and the cautionary, life-saving screenings that can help.

What is a prostate screening or exam?

A screening is a process in which certain early symptoms and signs are sought out and dealt with if found. When prostate cancer is found in its earliest stages, the chance of wholly healing is much higher.

Who needs a prostate exam?

The worldwide general consensus states that all males over fifty years of age with an average risk should be screened for prostate issues once at fifty, and again every ten years thereafter. Certain other circumstances push specific categories of males into different risk groups. African American men or anyone with an immediate blood relative (such as a father, brother or son) that was diagnosed before the age of sixty-five should begin prostate exams at age forty-five. If you are a male from a family with multiple prostate cancer diagnoses, you should begin your screenings at the age of forty. There are ever-changing medical thoughts across the board on the validity of stating screenings are necessary for men. Even with cancer numbers on the rise, certain medical groups still do not back or believe that routine screenings are necessary.

What types of tests are done in an exam?

There are two main tests done during a prostate screening evaluation. One is called a “DRE” which stands for Digital Rectal Exam, and the other is called the “PSA,” which stands for the prostate-specific antigen test. These tests are not used to find the actual cancer if it is there, but they do reveal the strong signs that a further biopsy or testing would be needed. The PSA is done by blood test, and upon permission, the DRE is usually performed at the same time. The DRE is completed by the doctor or physician’s assistant with a lubricated, gloved finger, and they palpitate the prostate through the anus and rectum to check for any abnormalities.

What are the details with the PSA test?

The PSA test is a blood test, where levels of PSA are read and recorded. Higher levels can signify there is a problem or prostate cancer. Certain factors can alter the results of a PSA test, and doctors usually will not do the test if any of the following is happening:

  • a urine infection
  • ejaculated within the previous forty-eight hours
  • exercised heavily in the previous forty-eight hours
  • had a prostate biopsy within the previous six weeks

Other things that can alter results of a PSA test are age and ethnicity, which your doctor will take into account at the time of testing. Levels can also be affected, though not as heavily, by these situations:

  • certain medications
  • certain medical procedures
  • an enlarged prostate
  • a prostate infection

The PSA test will take up to fourteen days on the average to complete. If the PSA numbers are normal, the doctor might want to see this male patient every one or two years to reevaluate. If the PSA numbers are high, the doctor will bring the male patient in for more testing, including a DRE and possible biopsy.

The DRE sounds unappealing. What is involved with the DRE?

This is a very uncomfortable procedure for many men, both physically and mentally. Although, many would tell you that the mental side might “hurt” a bit more than the physical temporary discomfort. Generally, the DRE is a quick process that is more awkward than painful.

To begin, the doctor will lubricate their gloved finger, and insert it gently into the anus and rectal canal. The purpose of this is to give the doctor direct contact with the prostate to feel for any soft spots, hard spots, size, and any other abnormalities that might be present. Because so many cases of prostate cancer begin in the “back” of the prostate, this method makes discovery and treatment easier. In cases where the prostate is enlarged, this process could be slightly more uncomfortable. If you have hemorrhoids or anal fissures, be sure to let your doctor know before they begin.

If you are still feeling uneasy about this procedure, consider arming yourself with more information by taking these questions with you to your appointment and discussing with your doctor directly.

  • What is your procedure for the DRE?
  • How accurate is the DRE in cancer detection?
  • Will it be painful?
  • How will the results be given?
  • Who will go over my results with me?
  • If the results suggest cancer, what further tests will need to be done?
  • Is this procedure covered by my insurance company?
  • Are there any side effects of this procedure?

Do not let your fear of the unknown prevent you from getting this very important exam! Stand up for yourself and your health and get checked! Consult with your primary care physician on how to get started.

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