What to Expect from a Prostate Examination

A prostate examination is a routine part of an annual physical for men aged 50 or older. It is used to screen for abnormalities in the prostate that might indicate prostate cancer. There is some controversy over the value of screening and early detection for prostate cancer, especially since most prostate tumors grow slowly and are not fatal; some tumors, however, can be aggressive and impact a person quickly. Knowing your status means you can make an informed decision regarding treatment for prostate cancer, if necessary.

The exam
The prostate examination typically involves a digital rectal exam and a prostate specific antigen (PSA) test. Together, these tests give your doctor an idea of the health of your prostate.

The prostate is a small organ, about the size of a walnut, located just below the bladder and just in front of the rectum. This position makes it easy for the doctor to feel it through the rectum. This manual exam of the prostate is called a digital rectal examination (DRE).

In the DRE, your doctor inserts a gloved finger into your rectum to feel the prostate, looking for any abnormalities. These might include hard areas, lumps or swelling. Not all abnormalities are cancer, but any unusual findings should be checked out further.

The PSA test is a simple blood test. Elevated PSA levels are an indicator of abnormalities in the prostate. This test is not specific to prostate cancer, but the higher the levels, the more likely cancer is present. Elevated PSA levels combined with abnormalities found during the DRE are a reason to look closer for the cause of the problem.

After the exam
Once your doctor has your test results, he will discuss his findings with you and, if necessary, the treatments for prostate cancer that are available. If only the DRE or the PSA are abnormal, your doctor may recommend watchful waiting, essentially to schedule more frequent screenings to see if the problem gets worse.

If both the DRE and the PSA are abnormal, the doctor may recommend a prostate biopsy. A biopsy involves removing a small bit of the prostate and examining it under a microscope. This is the only way to make a definitive diagnosis of prostate cancer.

Although prostrate screenings can be uncomfortable, they are an important part of a man's annual physical and might just save your life.

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