Today we are talking about a test that many men are a little hesitant to talk about, but it is definitely something that they should know about. That is the Prostate Exam. When you hear the name, some people feel a little scared, embarrassed, and uncomfortable. You may think, " Oh, I can't do that." But if we know exactly what is really going on in this, and why it is so important, all that fear and discomfort will disappear. This is a very important test that can help protect your life. So let's talk about this openly and honestly.
Simply put, what is a prostate exam?
A prostate exam is a test that checks for early signs of prostate cancer. It is like a screening test that we do to detect a disease before it develops. It has two main parts.
1. PSA blood test: The full name of this is the ``Prostate-Specific Antigen`` blood test. PSA is a protein produced by our prostate gland. This test measures the level of PSA in your blood.
2. Digital Rectal Exam (DRE): This is the one that many people are afraid of. In this test, your doctor will carefully insert a gloved, lubricated finger into your rectum. He or she will feel the surface and edges of your prostate gland. This will help him or her feel for any unusual lumps, bumps, or hardness.
The important thing is that neither of these tests is 100% certain that you have cancer. They are only used to determine whether further testing is needed or if there is a risk. That is why they are called screening assessments, not diagnostic tests.
When should I take this test?
This is a question that many people have. According to the American Cancer Society, here are the age limits for getting this test done:
| Person category | Recommended age for first test |
|---|---|
| Men at average risk | At 50 years old |
| People at higher risk (e.g., if a family member, especially a father or brother, has had prostate cancer) | At 45 years old |
| Those at even higher risk (e.g., if several family members have had this cancer at a young age) | At age 40 or earlier (you should discuss this with your doctor) |
The main thing to remember is that you should talk to your doctor about this when you turn 50. He or she will decide the best time for you, based on factors like your family history.
Are a prostate exam and a colonoscopy the same thing? Or are they two?
This is also a point where many people get confused. Because both tests are performed in the rectum, some people think that they are the same. But in fact, these are two completely different tests.
Think of it this way: a DRE is like a doctor coming to the gate and looking at the porch. It means inserting a finger into the anus and feeling the prostate gland in front of it.
But a colonoscopy is like going into every room of your house. It involves inserting a flexible tube with a camera through your anus and examining the entire wall of your colon. A colonoscopy does not examine the prostate.
Another difference is that a DRE is something that can be completed in a few seconds in the doctor's office. However, a ``(Colonoscopy)'' is a test that takes a little longer in a hospital, where you are given IV sedation.
Do you need any special preparation before the test?
There is no need for much preparation, but there are a few things that will help you pass this test with ease.
The most important thing is to inform your doctor about any other medical conditions you have before the test. In particular,
- Hemorrhoids
- Anal fissures
- Anal tears
If you have any conditions, be sure to mention them. Then the doctor can perform the examination very carefully without causing you any pain or discomfort.
Another thing is, sometimes your doctor will tell you to avoid having sex for 48 hours before the test . This is because your PSA level may temporarily increase after ejaculation. This can cause the blood test results to be slightly different.
"Do I have to defecate before the test?"
This is also a problem for many people. No, you don't need to change your normal habits. If you feel the need to defecate before the test, it's okay to do so. But if you don't, don't worry about it. You won't feel like you need to defecate during the DRE test.
The other thing is, don't be embarrassed about what will happen if you get a little stool on your glove during the examination. These are very normal, common things for doctors. How many tests do they do in a day? So just think about your comfort.
What to expect during the test?
As we talked about before, there are two parts to this.
1. PSA blood test
This is very simple. Just like a regular blood test, a sample of blood is taken from your arm and sent to a lab to be tested. This will measure the level of PSA in your blood.
2. Digital rectal examination (DRE)
In this, the doctor will tell you to turn around on the examination table and keep your knees close to your chest. Or you may be asked to lean forward and place your hands on a table.
Then, the doctor will insert a gloved, well-lubricated finger into your rectum and palpate your prostate gland. Since cancer is most likely to develop in the back of the gland, this is the best way to examine that area. The doctor will look at the size, shape, and texture of the gland. That is, is it smooth, or does it have any lumps, bumps, or anything unusual?
"Does this hurt a lot?"
To be honest, the DRE test is usually not painful. But you may feel a little discomfort and a strange feeling. But it is over in a few seconds. So there is no reason to be afraid. Remember, if you have a condition like hemorrhoids, tell your doctor beforehand. Then he will be more careful.
What do the test results say?
You can get the results of the DRE test right away. The doctor will tell you immediately after the test whether everything is normal or if anything unusual was felt.
It usually takes about a day for the results of the PSA blood test to come back. Once the results are in, your doctor will call you to let you know if further testing is needed.
PSA levels can change over time for a variety of reasons. PSA levels can be elevated even without cancer. For example,
- Ejaculation
- Some medications
- Benign Prostatic Hyperplasia (BPH)
PSA levels can also increase for these reasons. So, if your PSA level is only slightly higher than normal, your doctor may tell you to get another PSA test in about six months.
What if the PSA level is very high?
If your PSA level is significantly high, your doctor will refer you to a urologist (a doctor who specializes in the urinary system) . He or she will do further tests to determine the cause. This may include an MRI scan or a prostate biopsy, which involves taking a small piece of tissue from the prostate gland.
When should you see a doctor?
- Even if you're over 50 , if you haven't had a prostate exam yet, be sure to see your doctor and make an appointment.
- If you belong to a higher risk group (that is, if someone in your family has had this cancer), you should consider this test as early as age 45.
- Additionally, if you experience any difficulty urinating , such as a slow stream, a frequent need to urinate, or a feeling of having to urinate after you've finished, see a doctor immediately. These could be symptoms of benign prostatic hyperplasia (BPH).
The important thing is that prostate cancer usually does not show any symptoms until it becomes severe. That is why it is very important to get this test done at the right age, without waiting for symptoms to appear.
It's normal for many people to be afraid of their first prostate exam. But once you're fully informed about the process, that fear can be overcome. Talk openly with your doctor about it. This test is the first and best step in detecting prostate cancer early. Early detection is the best key to successful treatment.
Take-Home Message
- A prostate exam is a test that detects prostate cancer early. This can help save your life.
- There are two main parts to this: the PSA blood test and the DRE (digital rectal exam).
- Talk to your doctor about this test, usually after age 50, or after age 45 if you are at higher risk.
- The DRE test is not painful, although it may feel a little uncomfortable, and it will be over in a few seconds. Don't worry.
- Just because your PSA level is elevated doesn't necessarily mean you have cancer. It just means you need to get tested further.
- Don't put off getting tested out of shame or fear. Early detection is the best way to ensure successful treatment.
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