What Is A Prostate Exam?
A prostate exam is a medical examination of the rectum and is performed by a physician on male patients. The purpose of this screening is to assess early signs of prostate complications and the potential for prostate cancer.2
The two tests performed are a digital rectal exam or DRE and a prostate-specific antigen test, also known as PSA. DRE is a physical examination.2
PSA is a blood test which detects a protein created by the prostate. Prior to 1994, PSA test were only used on patients diagnosed with prostate cancer. However, in 1994, the FDA approved the use of PSA and DRE tests as a form of screening for asymptomatic men.1
Why Is A Prostate Cancer Exam Important?
In addition to prostate cancer, prostate exams help identify other non-cancerous conditions that may cause prostate abnormalities.1 In a recent study, researchers sought to identify the clinical usefulness of DRE as part of the assessment for prostate cancer. It was noted that DRE tests helped successfully identify individuals at risk of developing prostate cancer, even if their PSA was recognized as normal. It was also observed that patients that received a DRE within ten years of diagnosis, had a significantly reduced risk of mortality.2
What Kind of Doctor Does Prostate Exams?
A prostate examination does not have to be performed by a particular doctor. Your primary care physician should be capable of administering the test. Surgeons, nurses, and other medical specialists are also qualified.
Prostate Exam Age Recommendation
For readers wondering when to get a prostate exam, the recommend age has been the point of debate in recent years. While the risk of developing prostate cancer has been shown to increase with age, conducting prostate exams for men that are too young or at a low risk may cause unnecessary stress or anxiety.3
It has been suggested by some medical practitioners that men should begin basic prostate exams starting in their 40s. This may help evaluate if patients are at an increased risk. 5
According to the American Cancer Society, for men at an average risk, the recommend age for prostate examinations is 50.3 While the exact cause of prostate cancer is unknown, age has been identified as a contributing factor to prostate cancer development.
For readers wondering ”do I need a prostate exam?” there are several factors that may increase the need to get tested. Individuals with immediate family members that have had prostate cancer may be at an increased risk. These relatives are typically a father or a brother. Individuals suffering from obesity are also at an increased risk.3
Race may also be a contributing risk factor. While the mechanisms are not fully understood, men of African descent have been noted to have an increased risk of developing prostate cancer and overall higher mortality rates.3,5
It’s recommend to talk with your health care provider to help assess your risk factors. For men at an increased risk, it’s recommended to start screenings at age 45. For men at severe risk, age 40.3
How to Prepare for a Prostate Exam
Before any prostate exam, it’s important to let your health care provider know if you are taking any medications. Certain medications such as Propecia for hair loss, Proscar, and Adovart for benign prostate enlargement have the potential to alter PSA levels.5
It’s also suggested to for patients to schedule the PSA test prior to the DRE examination, as the rectal exam may falsely raise PSA levels.5
For those undergoing their first prostate exam, patients are encouraged to be cooperative and remain calm, as this aids in an effective evaluation. It has been noted that during the DRE portion of the examination, patients may feel the need to defecate.4
What Happens During a Prostate Exam
How is a prostate exam done? – Getting your prostate checked typically involves two procedures. It is important to note that there are no specific prostate exam tools required for this examination. During the DRE segment, you will be asked to lie on your side with your legs brought up your chest or you will be requested to bend at the waist while standing.
Once you are in the right position, a doctor or nurse inserts a gloved and lubricated finger into the rectum. This action is performed as it enables them to examine the size of the prostate, and feel for any bumps, or abnormalities.3
During the PSA test, a blood sample is drawn to measure PSA levels. It may take up to two weeks to receive the results of this blood test.
Do Prostate Exams Hurt?
A prostate exam does not hurt. For some men, there may be slight pain during the prostate exam, however, this is brief and will subside after the examination. If a significant amount of pain is felt, this may be an indication that the prostate is swollen or enlarged.
Usually, there are no side effects of prostate examinations. Patients can typically return to their regular activities without delay. Some men may experience small amounts of bleeding after prostate exams due to small tears or irritation of hemorrhoids. If excessive bleeding occurs, patients are encouraged to consult their doctor.
Can I Do A Self Prostate Exam Instead?
When it comes to checking your prostate, self exam is not recommended. It is best to seek the attention of doctor as they are aware of what to look for and can appropriately assess abnormalities. A prostate check is performed by doctors to support the well-being of their patients and are an effective in lowering the number of men affected by prostate cancer.
Scientific Research Referenced in this Article
- National Cancer Institute. (2017, October 4). Prostate-Specific Antigen (PSA) Test. Retrieved December 10 2017, from – View Reference
- Walsh, A. L., Considine, S. W., Thomas, A. Z., Lynch, T. H., & Manecksha, R. P. (2014). Digital rectal examination in primary care is important for early detection of prostate cancer: a retrospective cohort analysis study. The British Journal of General Practice, 64(629), e783–e787. http://doi.org/10.3399/bjgp14X682861
- Mayo Clinic. (2015, October 22). Prostate cancer screening: Should you get a PSA test? – View Reference
- Queen’s University: School of Medicine. (n.d.). Digital Rectal Exam & Anoscop – Patient Preparation. Retrieved December 10 2017 from http://meds.queensu.ca/central/assets/modules/ts-anoscopy/patient_preparation.html
- Worthington, J. F. (n.d.). Prostate Cancer: When Should I Be Screened? – View Reference