Prostate cancer is one of the most common cancers diagnosed in men, forming in the gland situated just beneath the bladder. Because this cancer often progresses slowly, early detection through screening is directly linked to a higher chance of successful treatment. Finding it early depends entirely on professional medical guidance, not on personal checks. Screening involves specific tests performed by a healthcare provider, designed to catch the disease before any noticeable symptoms appear.
Clarifying the Term “Self-Exam”
The concept of a traditional physical self-exam, similar to what is recommended for testicular or breast health, does not apply to the prostate. The prostate gland is located deep within the body, positioned in front of the rectum and below the bladder, making it physically inaccessible for a reliable self-examination. Any meaningful physical assessment must be conducted by a trained medical professional.
There is no standard, medically recommended self-check procedure for the prostate gland. Awareness must be focused on understanding the professional screening process and recognizing potential warning signs. The only way to proactively look for this cancer is by engaging in scheduled screening with a doctor, which utilizes specific clinical tools.
Physician-Led Screening Tools
Prostate cancer screening typically involves two distinct methods utilized by healthcare professionals. The first is the Prostate-Specific Antigen (PSA) blood test, which measures the level of a protein produced by the prostate gland. Elevated PSA levels can suggest the presence of cancer, though they can also be raised by other factors such as an enlarged prostate or infection.
The second method is the Digital Rectal Exam (DRE), where a doctor inserts a gloved, lubricated finger into the rectum to physically feel the prostate. This allows the physician to check for abnormalities in the gland’s size, shape, or texture, such as hard or lumpy areas. While the DRE is less effective than the PSA test, it can sometimes detect tumors located in the back of the gland. Many doctors recommend using both the PSA test and the DRE together, as they offer complementary information about the prostate’s condition.
Establishing a Screening Schedule
Deciding on a schedule for prostate cancer screening is a highly individualized process that involves a conversation with a healthcare provider. The general recommendation for men at average risk is to start the discussion about screening at age 50, provided they have a life expectancy of at least ten more years. This conversation should cover the potential benefits of finding cancer early against the risks of overdiagnosis and resulting treatment side effects.
Men considered to be at higher risk are advised to start the screening conversation sooner. This includes African American men and those with a father or brother diagnosed with prostate cancer before age 65, who should begin discussing screening at age 45. For men with multiple first-degree relatives diagnosed at an early age, the discussion should begin even earlier, around age 40. These earlier starting ages reflect the increased statistical likelihood of developing the disease within these groups.
The frequency of subsequent screenings is generally determined by the initial PSA blood test result. If a man chooses to be tested and his PSA level is low, specifically below 2.5 nanograms per milliliter (ng/mL), retesting may only be necessary every two years. Conversely, if the PSA level is higher, at 2.5 ng/mL or above, a yearly screening schedule is typically recommended to closely monitor the prostate. The U.S. Preventive Services Task Force recommends that men aged 55 to 69 make an individual decision about periodic PSA testing, but advises against routine PSA-based screening for men aged 70 and older.
Recognizing Potential Warning Signs
While professional screening aims to find prostate cancer before it causes problems, certain physical changes warrant an immediate doctor visit. Symptoms often arise when the tumor has grown large enough to press on the urethra or has advanced outside the prostate gland. Changes in urination are the most common signs, including difficulty starting the flow, a weak or slow urine stream, or a frequent need to urinate, especially at night.
Other signs include the presence of blood in the urine or the semen, which can sometimes indicate advanced disease. Unexplained pain in the back, hips, or pelvis may also signal that the cancer has spread to the bones. These symptoms can often be caused by non-cancerous conditions, such as benign prostatic hyperplasia (BPH) or a urinary tract infection, but a medical evaluation is necessary to determine the exact cause.