What is a prostate exam?

A prostate exam is a screening test for men to detect early signs of prostate cancer. Generally, men age 50 should start introducing a prostate exam in their self-care practices. 

Thanks to the minimally intrusive nature of a prostate exam, doctors resort to it on a regular basis. This allows them to pay attention to early signs of prostate cancer, which are not visible with the naked eye. Although a prostate exam never leads to a conclusive prostate cancer diagnosis, its input helps doctors decide whether a prostate biopsy is needed or not.

Continue reading and learn more about the proper age when men should start prostate checks, how to prepare before a prostate exam, what happens during the procedure, and more. 

What is a prostate examination?

A prostate examination is also known as a digital rectal exam and it entails a doctor inserting his or her gloved finger (digit) into the rectum. The doctor feels for any abnormal surfaces and growths. 

This empiric examination is usually backed up by a PSA blood test. This routine checkup measures the level of Prostate-Specific Antigen (PSA) in the blood. If the results come back with abnormal PSA quantity in the blood, and the prostate exam concluded with the presence of unusual lumps, then the healthcare provider may suggest a prostate biopsy on grounds of prostate cancer concerns. 

At what age should you get your prostate checked?

It’s important to understand what a difference routine screening can make in a person’s quality of life. The sooner prostate cancer is detected, the better the odds are for a full recovery. 

Therefore, the screening method for prostate cancer doesn’t start with the feeling of discomfort in the penile area. Instead, it starts when men are seemingly in a healthy condition, but they approach a certain age when it is likely to appear early signs of prostate cancer according to statistics.

Therefore, the number of prostate cancer diagnosis recorded in the last 10 years indicate that men should consider periodic prostate tests at the age of 50. In some cases, where the family history indicates a genetic predisposition to prostate cancer cells, general doctors can prescribe their patients routine prostate exams at age 45. 

At what age should you stop PSA testing?

The general recommendation for men is to start prostate cancer monitoring at the age of 50. This action can prevent around 1 cancer death for every 1,000 men that are checking for prostate cancer.

Nonetheless, the medical world issued guidelines for the appropriate time to terminate PSA testings as well. Studies indicate that men over the age of 70 can stop undergoing prostate exams, including PSA testing. In case life expectancy is less than 10 years due to serious health issues other than prostate cancer, then patients can skip PSA exams. 

On the other hand, statistics foresee 2.5 times higher increase of prostate cancer diagnoses by 2030 compared to 2017. Considering that the risk of developing prostate cancer increases with age, men over 70 should continue with their PSA tests. 

What does a prostate exam feel like?

A prostate exam necessitates physical contact in an area that is intimate and sensitive. That being said, doctors performing the test take all the necessary precautions to reduce the risk of any pain.

For this reason, doctors handle the exam equipped with gloves and lubricant. The moves performed within the rectum consist of gentle gestures meant to feel the area. All in all, the procedure lasts no more than 10 minutes and there is no lingering pain. Patients are feeling momentary disconfort during their prostate exams. There might also be a tingling sensation of the need to urinate.

Nonetheless, these sensations are unlikely to persist after the procedure. At the end of the prostate exam, the doctor is ready to inform on the condition of the prostate gland, whether it is of normal size or enlarged.

What does an enlarged prostate feel like on exam?

Doctors performing a prostate exam are well versed in how a healthy prostate feels versus a diseased one. For that matter, a healthy prostate is recognized by its smooth surface. 

On the other hand, an ill prostate gland is swollen, so it its size is unusually larger. What’s more, the surface gets hard and it can be full of lumps.

What is a digital rectal exam?

DRE exam is short for digital rectal exam. It consists of the physical part of a prostate exam and concerns only the 10-minute procedure when the doctor feels the inside of the rectum with the help of a single gloved finger.

Since prostate cancer manifests as an abnormal mass in the anus or rectum, doctors can distinguish a tumor in the prostate gland by feeling the tissue. During the digital rectal exam, the doctor examines 3 areas: lower rectum, lower belly, and pelvis. 

In terms of what a rectal exam can detect, doctors resort to it in order to:

• Identify signs of rectal tumors;
• Check for prostate cancer or prostate infection;
• Collect samples for a fecal occult blood test to keep track of signs of gastrointestinal bleedings or colon tumors;
• Investigate the condition of the anal sphincter in case of fecal incontinence;
• Analyze hemorrhoids;
• Identify sources of rectal bleedings.

What is a PSA exam?

A PSA exam usually comes after DRE with the purpose of measuring the quantity of Prostate-Specific Antigen in the blood. Only 2 sources produce this type of protein in the male body: the prostate gland and a prostate tumor. Any reading that reveals an abnormal quantity of the PSA protein in a patient is going to prompt doctors to further investigate for signs of prostate cancer.

This blood test cannot be taken as an official prostate cancer diagnosis. That’s because there might be other explanations for the increased number of PSA. An inflamed prostate or certain medications can generate more PSA protein than usual which can mislead doctors. Therefore, a PSA exam result with unusual readings leads to further examinations instead of a diagnosis.

What are prostate exams for?

Doctors recommend healthy men who reach the age of 50 to undergo regular prostate exams. But what is the point of a prostate exam if the blood tests show good results?

Prostate exams are part of surveillance programs. These efforts are put in place to detect prostate tumors during those stages when they are highly treatable, meaning the early stages. 

Prostate exams are quick 10-minute procedures that keep in check the most common form of cancer among American men. 

During their lifetime, 1 in 7 US men is going to receive a prostate cancer diagnosis. Regular prostate exams ensure the diagnosis is made when the tumor is still confined within the prostate gland and hasn’t affected other vital organs. This is the moment when the survival rate nears 100%.

What should you do before prostate exam?

Prostate exams need no preparations beforehand. Some men might feel responsible for emptying their bowels before a prostate exam. However, doctors reassure their patients that there is no need to worry about the fecal matter during the prostate exam. They are professional staff that know how to handle the situation so as their patients feel comfortable and safe at all times.

There are other concerns regarding the need of a fasting period before prostate exam. This consideration also relates to the bowel movement before prostate exam. Nonetheless, patients have no need to deviate from their eating and drinking habits before their doctor appointment.

What happens during a prostate exam?

First, patients are invited to undress and put on a hospital gown. During the test, your doctor allows you to find a comfortable position. It can either be:

• Bending over the table;
• Lying on your side;
• Taking a squatting position on the table;
• Lying on the table with the feet in stirrups.

Afterwards, the doctor is ready to begin the examination. With a gloved and lubricated finger, the doctor starts assessing the size of the prostate by feeling. The specialist can determine whether the prostate gland is in good condition or it is inflamed. Then, using the same finger, the doctor proceeds to feeling for any lumps in the rectum.

Prostate examination can take anything between a few seconds and 10 minutes. The doctor may hold down the lower abdomen during the exam.

What happens after a prostate exam?

The doctor can tell you right after a prostate exam his or her observations at first hand. However, doctors need further test results to confirm their premises.

In case your doctor finds an abnormal aspect of the prostate gland, the next step is the recommendation for further tests. These can be a biopsy, sigmoidoscopy, colonoscopy, or proctoscopy. For these tests, you will need a second appointment.

There may also be a PSA test, which the doctor can perform right away. It can take one to two weeks to receive the results for a PSA test.

What type of doctor does prostate exams?

You can talk to an urologist for a prostate exam. An urologist is trained in treating problems at the level of the urinary tract but also handles any condition regarding the male reproductive system.

Nonetheless, a general practitioner is also qualified to perform PSA blood tests and digital rectal exams. 

In case the test results detect signs of a prostate condition, the tests are either repeated or the patient is sent to the urologist to perform a prostate biopsy. This procedure can confirm the nature of the prostate disease. From there, the patient is sent to a specialist trained in that particular prostate condition.