A prostate exam is a common medical screening that helps assess the health of the prostate gland. Understanding the steps involved can help alleviate concerns. These exams are quick and a routine part of men’s health check-ups.
Purpose of a Prostate Exam
Prostate exams detect conditions affecting the prostate gland, located below the bladder and surrounding the urethra. A primary reason is the early detection of prostate cancer, the most common cancer in men (excluding skin cancer). Early detection improves treatment outcomes.
Beyond cancer, these exams also help identify other treatable conditions, such as benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate, or prostatitis, an inflammation of the gland. Regular screenings are recommended for men starting around age 50, or earlier (age 45) if higher risk factors exist, such as a family history of prostate cancer or for African American men. Monitoring prostate health over time is beneficial, especially for individuals with risk factors.
The Digital Rectal Exam (DRE)
The Digital Rectal Exam (DRE) is a physical assessment allowing a healthcare provider to directly feel the prostate gland. Patients may be asked to empty their bladder for comfort. They will be positioned on their side with knees bent towards the chest, or standing and bending forward at the waist.
The healthcare provider will wear a lubricated glove and gently insert one finger into the rectum. The prostate gland is located in front of the rectum, allowing the doctor to feel its size, shape, and texture. The doctor will be checking for any hard areas, lumps, nodules, or other irregularities on the surface of the gland.
The DRE is a quick procedure, usually lasting less than a minute. While it may cause a sensation of pressure or slight discomfort, it is generally not painful. Patients might feel the urge to urinate during the exam due to the pressure on the prostate. Healthcare providers are trained to perform this procedure professionally, and any initial awkwardness typically subsides quickly.
The Prostate-Specific Antigen (PSA) Blood Test
The Prostate-Specific Antigen (PSA) blood test is often performed with a DRE for a comprehensive prostate health assessment. PSA is a protein produced by both normal and cancerous cells within the prostate gland. A blood sample is drawn from a vein in the arm, a process that usually takes less than five minutes.
Once collected, the blood sample is sent to a laboratory for analysis to measure PSA levels. Elevated PSA levels can indicate various prostate conditions, including benign prostatic hyperplasia, prostatitis, or prostate cancer. A high PSA level alone does not definitively confirm cancer; it merely suggests that further investigation may be warranted.
Factors such as age, recent ejaculation, or certain medications can influence PSA levels. Therefore, the PSA results are interpreted by the doctor in the context of the DRE findings, a patient’s medical history, and other relevant factors to determine the next steps. Higher PSA levels generally increase the likelihood of prostate cancer, but there is no specific “normal” or “abnormal” cutoff.
What to Expect After the Exam
Following a prostate exam, patients can resume normal daily activities immediately. Digital rectal exam results are usually discussed right away with the healthcare provider. PSA blood test results are typically available within a few days to about a week.
If DRE and PSA test results are within expected ranges, the doctor will advise on scheduling the next routine screening, which could be in one to two years depending on individual risk factors. If either test shows an abnormal finding, such as an elevated PSA level or a suspicious area detected during the DRE, further diagnostic tests may be recommended. These additional steps could include repeating the PSA test, advanced imaging like an MRI, or a prostate biopsy to examine tissue samples for cancer cells.