A prostate exam evaluates the health of the prostate gland, a walnut-sized organ located in men just below the bladder and in front of the rectum. This assessment helps identify potential issues.
Why a Prostate Exam is Performed
Healthcare providers recommend prostate exams to screen for prostate health issues. They aid in the early detection of conditions such as prostate cancer, benign prostatic hyperplasia (BPH), an enlarged prostate, and prostatitis, an inflammation of the prostate gland. Early detection of prostate cancer can improve treatment outcomes. Prostate exams are often a routine part of men’s health check-ups, particularly for those in certain age groups or when specific urinary symptoms are present.
Digital Rectal Exam (DRE) Procedure
The Digital Rectal Exam (DRE) is a physical examination where a healthcare provider manually assesses the prostate gland. Before the exam, the patient prepares by removing clothing from the waist down and wearing a gown. The patient is often asked to lie on their side with knees bent towards the chest or to stand and bend forward at the waist.
The healthcare provider then puts on a glove and applies a lubricating gel to their index finger. The lubricated finger is gently inserted into the rectum to feel the prostate’s back surface. During this part of the exam, the provider assesses the prostate’s size, shape, and texture, feeling for any hard areas, lumps, or abnormal growths. The DRE typically lasts only a few minutes and while it may cause slight discomfort or pressure, it should not be significantly painful.
Prostate-Specific Antigen (PSA) Blood Test
The Prostate-Specific Antigen (PSA) test is a blood test that measures the level of PSA, a protein produced by the prostate gland, in the bloodstream. A healthcare professional collects a blood sample, usually from a vein in the arm, using a small needle. This process typically takes less than five minutes. It is generally advised to avoid ejaculation and vigorous exercise for 24 to 48 hours before the test, as these activities can temporarily increase PSA levels, potentially affecting the accuracy of the results.
The collected blood sample is then sent to a laboratory for analysis, where the amount of PSA is measured, commonly in nanograms per milliliter (ng/mL). PSA is present in small amounts in the blood of all men, but elevated levels can be an indication of prostate issues. While a high PSA level can suggest the possibility of prostate cancer, it can also be raised by non-cancerous conditions such as an enlarged prostate (BPH), inflammation of the prostate (prostatitis), or urinary tract infections.
Understanding Your Results
After a prostate exam, the results from both the Digital Rectal Exam and the PSA blood test are communicated by the healthcare provider. For the DRE, the provider can often share findings immediately, noting if the prostate felt normal, enlarged, or had any suspicious areas. PSA test results are typically available within one to two weeks, showing the measured level of the PSA protein. It is important to understand that there is no single “normal” or “abnormal” PSA level, as levels can vary based on age and individual factors.
Elevated PSA levels or unusual DRE findings do not automatically mean prostate cancer is present. Instead, these results indicate further investigation may be necessary to determine the cause. This might involve additional PSA tests to monitor changes over time, or other diagnostic procedures such as imaging tests or a prostate biopsy, which is the only definitive way to diagnose prostate cancer. Discussing these results with a healthcare provider is important for personalized advice and to decide on any next steps.