Wellbeing
What to Expect During Your Prostate Exam
http://www.everydayhealth.com/prostate-cancer/what-to-expect-during-you…
What to Expect During Your Prostate Exam
If you've been avoiding a prostate exam, you could be putting your health at risk. Knowing the facts about the procedure will help put any fears, concerns, or squeamishness to rest.
By Chris Iliades, MD
Medically Reviewed by Farrokh Sohrabi, MD
If you're a man older than 40 and have not yet had a prostate exam, it's a good time to talk to your doctor. If you're also African American or have a family history of prostate cancer, it's a really good time. One of six men eventually gets a prostate cancer diagnosis. And even though most men have a slow-growing type, prostate cancer is still the leading cause of cancer deaths in men older than 75. So if you're afraid of a prostate exam, it's time get over it and protect your prostate health.
"Start talking about your prostate care plan at age 40, and if you and your doctor think the time is right, get a digital rectal exam and a PSA blood test during your annual physical," suggests Dan Zenka, senior vice president of the Prostate Cancer Foundation and a prostate cancer survivor who was diagnosed at age 51 in 2010.
What to Expect During a Primary Care Prostate Health Exam
Your doctor will probably start by asking you if you have any prostate health symptoms like a weak urine stream, dribbling, straining to urinate, or blood in your sperm or urine. Your doctor may also ask if you have a father or a brother with prostate cancer - and if the doctor doesn't ask, volunteer the information.
Digital rectal exam (DRE). This exam involves having a lubricated, gloved finger inserted into your rectum. You may have to bend over or lie on your side. It may hurt your dignity a little, but it's not painful. "Since your prostate is right there where your doctor can feel for any abnormalities, this is a really important exam for all men," says Zenka.
PSA blood test. PSA is prostate specific antigen, a protein that goes up with prostate cancer. However, you can have a high PSA without prostate cancer, and you can have prostate cancer without a high PSA. "PSA is not the perfect screening tool, but it is the best one we have," notes Zenka. "Think of it as a prostate cancer 'smoke alarm.' New screening blood tests are being developed that will eliminate the controversy over when and how to use PSA." It may take a few days to get the results of your PSA.
What to Expect if You Need a Prostate Cancer Exam
"If your primary care doctor feels something abnormal during your DRE or if you have a PSA above 4, you can expect to get another exam by a prostate cancer specialist," says Michael P. Feloney, MD, an assistant professor of urologic surgery at the Nebraska Medical Center in Omaha. Your urologist will ask you a lot of the same questions and you can expect another digital exam.
Here is what else may happen:
Free PSA blood test. "Your urologist may order this blood test to get more information about your PSA. PSA can travel through your blood, attached to other proteins or by itself. If less than 25 percent of your PSA is 'free,' your risk of prostate cancer is higher," says Dr. Feloney.
Trans rectal ultrasound (TRUS). If your urologist suspects prostate cancer after your history, DRE, and blood tests, he may order this test. TRUS is a 15-minute procedure that uses sound waves to create an image of your prostate gland. This image can help tell the difference between non-cancerous and cancerous changes in your prostate. You may need to have an enema the night before. You will lie on your side as a probe is passed into your rectum to do the test. There should be no pain.
Prostate biopsy. Getting tissue samples of your prostate gland to look at under a microscope is the only sure way to diagnose prostate cancer. Prostate biopsy is often combined with TRUS to guide your urologist to the site of the suspected cancer. A biopsy is an outpatient procedure. Most of the time, your prostate will be made numb with an injection and you will not be put to sleep. "The biopsy is done through the rectum, and 12 cores of prostate tissue are usually removed," says Feloney. "You may need to take some antibiotics and have an enema before the procedure. Tell your urologist if you take any blood thinners. After the biopsy, you may expect some blood in your urine for a few days."
"I felt a few zingers during the biopsy, but it went quickly," Zenka recalls. "I went home on antibiotics and Advil. The day after the biopsy, I went back to all my normal activities."
What You Will Learn From Prostate Cancer Tests
Results of your biopsy should be ready in about a week. They will show not only whether you have prostate cancer but, if you do, they'll also give a pretty good idea of how aggressive the cancer is.
Possible results include benign enlargement, inflammation, PIN, or cancer. PIN stands for prostatic intraepithelial neoplasia, which is a type of cell change that may become cancer. "The pathologist who looks at the biopsy will also grade the cells from 2 to 10," explains Feloney. "This is called the Gleason score. A Gleason score over 8 indicates a more aggressive type of cancer."
If you do get a prostate cancer diagnosis, there are many options for treatment. The good news is that prostate cancer is not a deadly disease for most men. In fact, studies show that the five-year survival after diagnosis is nearly 100 percent, and long-term survival at 15 years is over 90 percent - and these stats are getting even better over time as treatments improve. Prostate cancer is definitely a survivable disease, so don't be afraid to go ahead and have that prostate exam.
Can prostate cancer be found early? American Cancer Society. http://www.cancer.org/Cancer/ProstateCancer/DetailedGuide/prostate-canc…
What's new in prostate cancer screening and prevention? Cleveland Clinic Journal of Medicine, August 2009 vol. 76 8 439-445.http://www.ccjm.org/content/76/8/439.full
Interview with Dan Zenka.
Prostate cancer, National Library of Medicine, National Institutes of Health.http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001418/
Interview with Michael P. Feloney, MD.
Prostate cancer Transrectal Ultrasound, University of Pittsburgh Medical Center. http://www.upmccancercenters.com/cancer/prostate/biopsyultrasound.html
Survival rates for prostate cancer, American Cancer Society. http://www.cancer.org/Cancer/ProstateCancer/DetailedGuide/prostate-canc…
http://www.everydayhealth.com/prostate-cancer/what-to-expect-during-you…
What to Expect During Your Prostate Exam
If you've been avoiding a prostate exam, you could be putting your health at risk. Knowing the facts about the procedure will help put any fears, concerns, or squeamishness to rest.
By Chris Iliades, MD
Medically Reviewed by Farrokh Sohrabi, MD
If you're a man older than 40 and have not yet had a prostate exam, it's a good time to talk to your doctor. If you're also African American or have a family history of prostate cancer, it's a really good time. One of six men eventually gets a prostate cancer diagnosis. And even though most men have a slow-growing type, prostate cancer is still the leading cause of cancer deaths in men older than 75. So if you're afraid of a prostate exam, it's time get over it and protect your prostate health.
"Start talking about your prostate care plan at age 40, and if you and your doctor think the time is right, get a digital rectal exam and a PSA blood test during your annual physical," suggests Dan Zenka, senior vice president of the Prostate Cancer Foundation and a prostate cancer survivor who was diagnosed at age 51 in 2010.
What to Expect During a Primary Care Prostate Health Exam
Your doctor will probably start by asking you if you have any prostate health symptoms like a weak urine stream, dribbling, straining to urinate, or blood in your sperm or urine. Your doctor may also ask if you have a father or a brother with prostate cancer - and if the doctor doesn't ask, volunteer the information.
Digital rectal exam (DRE). This exam involves having a lubricated, gloved finger inserted into your rectum. You may have to bend over or lie on your side. It may hurt your dignity a little, but it's not painful. "Since your prostate is right there where your doctor can feel for any abnormalities, this is a really important exam for all men," says Zenka.
PSA blood test. PSA is prostate specific antigen, a protein that goes up with prostate cancer. However, you can have a high PSA without prostate cancer, and you can have prostate cancer without a high PSA. "PSA is not the perfect screening tool, but it is the best one we have," notes Zenka. "Think of it as a prostate cancer 'smoke alarm.' New screening blood tests are being developed that will eliminate the controversy over when and how to use PSA." It may take a few days to get the results of your PSA.
What to Expect if You Need a Prostate Cancer Exam
"If your primary care doctor feels something abnormal during your DRE or if you have a PSA above 4, you can expect to get another exam by a prostate cancer specialist," says Michael P. Feloney, MD, an assistant professor of urologic surgery at the Nebraska Medical Center in Omaha. Your urologist will ask you a lot of the same questions and you can expect another digital exam.
Here is what else may happen:
Free PSA blood test. "Your urologist may order this blood test to get more information about your PSA. PSA can travel through your blood, attached to other proteins or by itself. If less than 25 percent of your PSA is 'free,' your risk of prostate cancer is higher," says Dr. Feloney.
Trans rectal ultrasound (TRUS). If your urologist suspects prostate cancer after your history, DRE, and blood tests, he may order this test. TRUS is a 15-minute procedure that uses sound waves to create an image of your prostate gland. This image can help tell the difference between non-cancerous and cancerous changes in your prostate. You may need to have an enema the night before. You will lie on your side as a probe is passed into your rectum to do the test. There should be no pain.
Prostate biopsy. Getting tissue samples of your prostate gland to look at under a microscope is the only sure way to diagnose prostate cancer. Prostate biopsy is often combined with TRUS to guide your urologist to the site of the suspected cancer. A biopsy is an outpatient procedure. Most of the time, your prostate will be made numb with an injection and you will not be put to sleep. "The biopsy is done through the rectum, and 12 cores of prostate tissue are usually removed," says Feloney. "You may need to take some antibiotics and have an enema before the procedure. Tell your urologist if you take any blood thinners. After the biopsy, you may expect some blood in your urine for a few days."
"I felt a few zingers during the biopsy, but it went quickly," Zenka recalls. "I went home on antibiotics and Advil. The day after the biopsy, I went back to all my normal activities."
What You Will Learn From Prostate Cancer Tests
Results of your biopsy should be ready in about a week. They will show not only whether you have prostate cancer but, if you do, they'll also give a pretty good idea of how aggressive the cancer is.
Possible results include benign enlargement, inflammation, PIN, or cancer. PIN stands for prostatic intraepithelial neoplasia, which is a type of cell change that may become cancer. "The pathologist who looks at the biopsy will also grade the cells from 2 to 10," explains Feloney. "This is called the Gleason score. A Gleason score over 8 indicates a more aggressive type of cancer."
If you do get a prostate cancer diagnosis, there are many options for treatment. The good news is that prostate cancer is not a deadly disease for most men. In fact, studies show that the five-year survival after diagnosis is nearly 100 percent, and long-term survival at 15 years is over 90 percent - and these stats are getting even better over time as treatments improve. Prostate cancer is definitely a survivable disease, so don't be afraid to go ahead and have that prostate exam.
Can prostate cancer be found early? American Cancer Society. http://www.cancer.org/Cancer/ProstateCancer/DetailedGuide/prostate-canc…
What's new in prostate cancer screening and prevention? Cleveland Clinic Journal of Medicine, August 2009 vol. 76 8 439-445.http://www.ccjm.org/content/76/8/439.full
Interview with Dan Zenka.
Prostate cancer, National Library of Medicine, National Institutes of Health.http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001418/
Interview with Michael P. Feloney, MD.
Prostate cancer Transrectal Ultrasound, University of Pittsburgh Medical Center. http://www.upmccancercenters.com/cancer/prostate/biopsyultrasound.html
Survival rates for prostate cancer, American Cancer Society. http://www.cancer.org/Cancer/ProstateCancer/DetailedGuide/prostate-canc…