Prostate Examination

After lung cancer, the incidence of prostate cancer is second highest in America. In fact, according to the latest statistics reported by American Cancer Society, one in every seven men is diagnosed with prostate cancer at some point in their life. Prostate examination or early screening can help reduce the death toll from prostate cancer. Early prostate detection involves screening for early signs of illness in stable and healthy individuals who are not experiencing any specific symptoms of disease. Prostate exams assist in early detection of cancer lesions and thus aid in improving the quality of life as the illness becomes rather difficult to treat in late stages.

Recommendation For Early Detection Of Prostate Cancer

Men over 50 years are strongly recommended to get periodically screened for prostate cancer. American Cancer Society has following recommendations for prostate examination:

• Men over 50 who have expectations of living 10 years and have average chances of developing prostate cancer.
• Men who are 45 and have pronounced chances of developing prostate cancer such as men with a son, brother or father diagnosed with the disease at an age below 65, or those of African-Americans descent.
• Men who are 40 and have 2 or more first-degree relatives diagnosed with the disease earlier in life.

Tests Included In Prostate Cancer Screening Exam

For screening of prostate cancers, two tests are commonly employed.

• Digital rectal exam (DRE)
• Prostate-specific antigen test (PSA)

These tests cannot confirm the disease but they can indicate such signs that may suggest the occurrence of prostate cancer. For confirmation, biopsy and other related tests are done. After the consent of the person to be screened, the DRE is done. It includes insertion of a lubricated gloved finger of a nurse or a doctor, into the rectum. This helps in analyzing the abnormalities and size of prostate as the cancer usually begins along the posterior margin of the gland. DRE is not painful under most cases and is usually very quick. If the screened man has anal fissure or hemorrhoids, then bleeding may occur after DRE is completed. If this bleeding is persistent then the person should immediately seek medical assistance.

PSA blood test takes roughly 14 days to be completed and is done to determine the serum level of PSA (a protein produced by the prostate). Increased levels of PSA in blood signify that there is some problem with the prostate. But there are many factors that can affect the levels of PSA like ethnicity, body weight and age. These levels may be altered by the following:

• Certain medical procedures
• Certain medications
• Enlargement of prostate
• Prostate infection

For the accuracy of the test result, the patient should ideally not:

• Have urine infection
• Exercise for 48 hours prior to the test
• Ejaculate for 48 hours prior to the test
• Have had any prostate biopsies 6 weeks prior to the test

Prostate gland is as small as a walnut and is located below the bladder in males. The gland surrounds the tube which transports urine to the penis from the bladder. This tube is referred to as urethra and is also responsible for carrying semen. The gland is majorly involved in the production of a fluid that makes up semen, along with the sperm cells.

References

• Heidenreich, A., Bastian, P. J., Bellmunt, J., Bolla, M., Joniau, S., van der Kwast, T., ... & Mottet, N. (2014). EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent—update 2013. European urology, 65(1), 124-137. Chicago
• Barry, M. J., Wexler, R. M., Brackett, C. D., Sepucha, K. R., Simmons, L. H., Gerstein, B. S., ... & Fowler, F. J. (2015). Responses to a decision aid on prostate cancer screening in primary care practices. American journal of preventive medicine, 49(4), 520-525.