What Is A Prostate Exam?
Screening means looking for early signs of a disease in healthy people who do not have any symptoms. The aim of screening is to diagnose disease at an early stage as it is easier to treat and more likely to be cured.
Who Should Get A Test Done?
Men worldwide over the age of 50 are strongly advised to have at least an informed discussion with their healthcare provider about screening for prostate cancer.
The American Cancer Society recommend that the discussion about screening should take place for men at the following ages:
50 years of age for men who are at average risk of prostate cancer and are expected to live at least 10 more years.
45 years of age for men at high risk of developing prostate cancer.
40 years of age for men with more than one first-degree relative who had prostate cancer at an early age.
Some groups do not recommend routine screening. The U.S. Preventive Services Task Force changed their recommendations in 2012 to recommend that men are not screened for prostate cancer.
What Tests Are Available?
There are two main tests commonly used to screen for prostate cancer. These are the digital rectal exam (DRE) and the prostate-specific antigen test (PSA).
Neither test can confirm prostate cancer. However, they can reveal strong signs that a man has a prostate problem and requires further testing such as a prostate biopsy.
Men who want to be screened should be tested with the PSA blood test. If a man gives his consent, the DRE is usually conducted as an early part of the screening.
In the DRE, a doctor inserts a gloved, lubricated finger into the rectum. They do this to check the size of the prostate and feel for abnormalities.
In the PSA test, a blood sample is taken so that the level of PSA in the blood can be measured. PSA is a protein made by the prostate.
commonly the blood test for PSA is taken before the DRE is done. DRE and pressure applied to the prostate can stimulate the release of PSA hence false elevating the PsA levels.
During The DRE
A DRE is generally not painful and only takes less than a minute to complete.
Prostate cancers often begin in the back of the gland, which may be felt during a rectal exam. If the prostate is enlarged, the patient may feel discomfort or mild pain during the exam.
After The DRE
Most men go back to their regular activities immediately after a DRE. There can be some mild bleeding if you have anal fissure or preexisting piles(haemorrhoids)
Several factors can affect PSA levels in a blood test
To guarantee an accurate test, a patient must not have:
a urine infection
ejaculated for 48 hours before
exercised heavily in the previous 48 hours
had a prostate biopsy within the last 6 weeks
These factors may raise the PSA level. Sometimes, a high PSA level may simply be due to increased activity or tension. Intense exercise, work, recent sex or a period of travel can lead to a rise in PSA.
What Happens After A PSA Test?
If the PSA level is normal, the healthcare specialist may leave further tests to the choice of the individual. They may decide to do the test every 1-2 years.
If the PSA level is high, the specialist is likely to refer the man for more tests. These tests might include an MRI of the prostate gland and possibly a prostate biopsy.
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