The prostate gland, a small organ about the size of a walnut, is located just below the bladder and in front of the rectum in males. It surrounds the urethra, the tube that carries urine and semen out of the body. The prostate’s primary function is to produce seminal fluid. A prostate exam serves as a routine screening tool, playing an important role in proactive health management.
Understanding the Purpose and Timing
Prostate exams screen for various prostate issues, including prostate cancer, Benign Prostatic Hyperplasia (BPH), and prostatitis. For men at average risk, discussions about beginning regular prostate exams often start around age 50. However, certain risk factors may necessitate earlier or more frequent screening.
Men with a higher risk, such as those of African American descent or individuals with a family history of prostate cancer in a first-degree relative, might consider starting screenings between ages 40 and 45. The risk increases if multiple family members were affected or if a relative was diagnosed at a younger age. These guidelines help healthcare providers recommend an individualized screening schedule.
The Prostate Exam Procedure
Qualified healthcare providers perform the Digital Rectal Exam (DRE), which involves a gloved finger inserted into the rectum to feel the prostate. The patient may be asked to stand and lean forward over an exam table or lie on their side with knees pulled towards the chest.
After applying lubricant to a gloved finger, the healthcare provider gently inserts their finger into the rectum. They then palpate the prostate gland, assessing its size, shape, and texture. The exam is typically quick, lasting only a few seconds to a minute or two. While generally described as causing a sensation of pressure or mild discomfort, it is not usually painful.
Interpreting Findings and Next Steps
During the DRE, a healthcare provider assesses the prostate for its size, shape, consistency, and any nodules or tenderness. A normal prostate typically feels smooth, firm, and rubbery, similar to the tip of a thumb, and is not tender. Abnormal findings might include an enlarged prostate, areas of hardness, lumps, or tenderness. An abnormal DRE finding does not automatically mean cancer; it indicates the need for further investigation. Next steps may include additional tests, such as a Prostate-Specific Antigen (PSA) blood test, imaging studies like an MRI, or a biopsy for a definitive diagnosis.
Complementary Screening Methods
The Prostate-Specific Antigen (PSA) blood test is a common complementary screening tool, often used alongside or in place of the DRE. This test measures PSA, a protein produced by both normal and cancerous prostate cells. An elevated PSA level can suggest various prostate conditions, including Benign Prostatic Hyperplasia, inflammation, or prostate cancer.
However, elevated levels do not definitively confirm cancer, as other factors can cause PSA to rise. There is no single “normal” PSA level, and levels can vary with age. Because of these complexities, deciding on prostate cancer screening, including the PSA test, involves a shared decision-making process with a healthcare provider, who can offer personalized advice.