Worried about your prostate? Let's talk about the prostate exam!

Today we are going to talk about a topic that many men are a little hesitant to talk about, but it is very important. That is the prostate exam . When you hear this name, some people may feel a little scared and uncomfortable. However, when you know exactly what this test is, why it is important, and who should have it, you will understand that it is not something to be afraid of. Let's talk about this in detail, shall we?

What is a prostate exam?

Simply put, a prostate exam is a test that checks for early signs of prostate cancer in men. The prostate is a small gland located below the bladder in men. It helps produce part of the fluid in semen.

This prostate exam usually has two main parts:

1. PSA (Prostate-Specific Antigen) blood test: This measures the level of a protein called `PSA` in your blood.

2. Digital Rectal Exam ( DRE ): In this, the doctor inserts a gloved finger (digit) into your rectum and feels the shape and surface of the prostate gland. This can help determine if there are any unusual lumps or swellings.

Neither of these tests can directly say, "Yes, you have cancer." These are considered screening assessments , not diagnostic tests.

Who should get this test done and when?

According to the American Cancer Society, it is a good idea for men to have their first prostate exam when they turn 50.

However, this age limit is not the same for everyone. Some people need to think about this before:

• If someone in your family (such as your father or brother) has had prostate cancer, it is wise to have this test done when you are 45 years old.
• Also, black men have been found to have a higher risk of prostate cancer , so doctors often recommend that they have their first test around age 45.

Talk to your family doctor about this.It's best to talk to them and decide on a time that suits you best.

Don't confuse a prostate exam with a colonoscopy!

Some people may think that a prostate exam and a colonoscopy are the same because both involve the rectum. However, these two tests are actually very different.

Think about it, a prostate exam (specifically a `DRE`) involves the doctor palpating the prostate with his finger. However, a `colonoscopy` involves inserting a flexible, camera-equipped tube through the anus to examine the walls of the colon. The prostate is not examined during a `colonoscopy`, unless the doctor performs a separate `DRE`.

Another thing is, a prostate exam is usually something that can be done in a doctor's office in a few minutes. But a colonoscopy is a test that is done in an outpatient department of a hospital and requires anesthesia (IV - Intravenous sedation). Do you understand the difference?

How to prepare for this test?

Actually, a prostate exam doesn't require much preparation. However, it's important to be aware of the following before you see your doctor:

• If you have hemorrhoids .
• If you have conditions like anal fissures .
• If you have anal tears .

Since the DRE test can be a bit difficult in these situations, it is best to inform the doctor about it in advance.

Another thing is that sometimes your doctor may tell you to avoid sexual intercourse for 48 hours before the test. This is because PSA levels can temporarily increase after ejaculation, which can affect the test results.

Do I have to defecate before the test? (A question many people have!)

No, there is no need to change your normal toilet habits. If you feel the need to defecate before the test, there is no problem in doing so. However, if you do not feel the need, do not worry. The prostate exam will not make you feel the need to defecate.

Some people may feel embarrassed about what will happen if they come across fecal matter during the test. Don't worry. Doctors are trained to perform this test, and they will do their best to make you feel comfortable.

What happens during the test?

As we've discussed before, there are two main tests that doctors use to diagnose prostate cancer: the PSA (Prostate-Specific Antigen) blood test and the digital rectal examination (DRE). Research has shown that the PSA blood test is more effective in detecting prostate cancer.However, some people with normal PSA levels can have cancer detected by DRE. Therefore, many doctors recommend both tests.

PSA (Prostate-Specific Antigen) blood test

It's very simple. The doctor takes a blood sample from your arm and sends it to a lab, where they measure the amount of a protein called PSA in your blood.

There is no specific cutoff score that says if the PSA value is above this, there is cancer, and if it is below this, there is no cancer. This result is used to help decide whether further testing is needed.

If your PSA level is high, your doctor may recommend a prostate biopsy, an MRI (Magnetic Resonance Imaging) scan, or other laboratory tests to check for prostate cancer .

Digital rectal examination (DRE)

During a DRE, your doctor inserts a gloved finger that has been lubricated into your rectum. This allows the doctor to feel the prostate gland and check for any lumps, swellings, or abnormalities in the back of the gland (where many cancers start). This takes a few seconds.

Is this test painful?

Although the DRE test may feel a little uncomfortable for some people, it is usually not painful. It also only takes a few seconds to complete.

If you have conditions like hemorrhoids or anal fissures, tell your doctor about them in advance. That way, he or she can help make the exam as easy as possible. Don't worry, doctors are very sensitive about this.

What do the results of the PSA test mean?

Once your PSA test results are in, your doctor will call you to explain them and tell you whether further testing is needed.

PSA levels are not always the same. PSA levels can also change for reasons unrelated to prostate cancer. For example, things like ejaculation, certain medications, or simply enlargement of the prostate can cause PSA levels to go up or down.

Therefore, if your PSA level is only slightly high (borderline), your doctor may recommend that you have another PSA test in about six months.

What to do if PSA level is high?

If your PSA level is significantly elevated, your doctor will likely refer you to a urologist for further testing and evaluation. This is where the next step will be determined.

How long does it take to know the results?

Typically, it takes about a day to get the results of a PSA blood test.

In the case of a `DRE` test, the doctor will tell you the results right away.Because it is a tactile test, the condition can be assessed immediately.

What are the occasions when you should see a doctor?

It is very important that you also take care of these things:

• If you are over 50 and have not had your first prostate exam, see a doctor immediately and make an appointment.
• If you are in a higher risk group (i.e., black or have a family history of prostate cancer), it is best to get this test done at age 45.
• Additionally, if you develop symptoms of urinary tract obstruction ( for example, difficulty urinating, frequent urination, incomplete emptying of the bladder), you should also see a doctor immediately. These may be caused by an enlarged prostate, benign prostatic hyperplasia (BPH) , or a urinary tract infection (UTI) .

Important: Prostate cancer usually does not show symptoms until it has developed to an advanced stage. That is why it is important to get tested at the right age, rather than waiting for symptoms to appear.

It's normal for many people to be a little nervous about their first prostate exam. However, the more you know about the process, the less nervous you can be. Talk openly with your doctor about these screening options. A prostate exam is the first step in early detection of prostate cancer - and early detection is the best key to successful treatment!

The most important thing to remember (Take-Home Message)

So, from what we've discussed today, you should have understood what a prostate exam is and what its importance is.

• Don't be afraid: this is a routine medical test.
• Be informed early: Get tested based on your age and risk factors.
• Talk to your doctor: Talk to your doctor about any questions or concerns you have.
• Early detection saves lives: If prostate cancer is detected early, the chances of treatment being successful are much higher.

So, don't be lazy about this. Take care of your own health . We hope this information was useful to you!

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