What is a prostate examination?
A prostate examination will involve an internal examination where a doctor will put on a latex glove and insert a lubricated finger into the rectum to feel and assess the prostate for abnormalities. The procedure is relatively quick and painless, although you may feel some slight discomfort during the examination.
What happens if abnormalities are detected during an examination?
If during your prostate examination your practitioner detects any abnormalities such as an enlarged prostate or a lump, your doctor will discuss the findings with you straight after the examination and further investigations will be explored. Further tests/screening may be required to determine the nature of the enlargement and to provide an accurate diagnosis.
Who should have a prostate examination?
Prostate screening is not formally undertaken for men, unlike bowel cancer. However, your GP will discuss prostate cancer screening with you. If you have any symptoms or signs that concern you about your urinary tract or genital function, you should seek advice. Signs and symptoms of prostate cancer include difficulties with urination (e.g. slow start, dribbling, poor stream) and if you have these symptoms, you should be checked for prostate enlargement. It is important that in your early forties, you discuss with your doctor any family history of prostate cancer to determine appropriate screening. If there is no family history of prostate cancer, then many men opt to have regular digital rectal examinations to check for prostate enlargement/abnormalities over the age of 50.
There is a blood test available, called the PSA test (or prostate specific antigen) which is controversial, as it is not a very accurate test, and can be misleading. This can either provide false reassurance if it is negative (false negative) or lead to over investigation and anxiety about a positive result when there is nothing wrong ( false positive). Doctors vary regarding how they advise their patients about the use of this test. Your doctor may suggest a rectal examination and a blood test if you would like to be “screened” for prostate cancer, but just having the blood test without any symptoms of prostate enlargement, or a rectal examination is not recommended. Care needs to be taken when interpreting the blood test results.
If the prostate is enlarged, but cancer has been excluded, then treatment is usually with oral tablets. This is known as benign prostatic hypertrophy (BPH). Sometimes surgery is necessary if the prostate becomes very enlarged. If the prostate is enlarged and/or the PSA is raised, then men will usually go on to have further investigations such as ultrasound, MRI and a biopsy. If prostate cancer is diagnosed and detected early enough, it can respond very well to treatment. With better prostate cancer treatments available, many men have a good prognosis.
At Choices Sexual Health our doctors can discuss with you a prostate screening program based on your family history and your current health. We offer a Men’s Health Clinic, so call us today to make an appointment.