How a Prostate Exam Is Carried Out

26 January, 2020
Getting a prostate exam is vital for men of certain ages. It allows you to detect prostate cancer early and treat it promptly.

The prostate exam is a subject that’s often taboo among men. For many, it means an invasion of privacy that they don’t want to experience. However, it’s been increasingly accepted with the passage of time.

The prostate is a gland that only males possess. It’s located below the bladder and surrounds the urethra. It has the function of producing liquids that will later become semen.

Over the years, the prostate gradually increases in size. This is a phenomenon that occurs to all men. We know that, at age 80, nearly 70% of men have abnormal prostate growths.

Prostate cancer is the most aggressive and deadly form. In addition, it’s one of the most common cancers among men and has significant mortality.

With women, the Pap smear and mammography are preventive oncological disease tools. In the same way, the prostate exam is a preventive tool for males.

A prostate exam initially involves two practices: the PSA test and the digital rectal exam. If either or both produce suspicious results, the medical professional passes to the second diagnostic phase, with imaging and prostate biopsy.

But firstly, before detailing each prostate exam, we’ll explain who needs to get them.

Prostate exam indications

It’s important to clarify that the prostate exam isn’t for all males. Medical science has established ages and protocols to determine who benefits from it and who doesn’t.

The main parameters are related to the patient’s age:

  • Over 50. These men have to get a prostate exam every year or every two years.
  • Between ages 45 and 50. This age group has to get this test if they have risk factors for prostate cancer. For example, the descendants of black races or those with a family member who was diagnosed with prostate cancer.
  • Under 40. It’s rare for a person under forty to have to get prostate exams. Medical professionals consider candidates those men with more than one close relative who was diagnosed with prostate cancer.

When a medical professional determines the need for a prostate exam, they’ll request a PSA test and digital rectal exam. This is performed with laboratory techniques through a blood sample and a digital rectal exam in the doctor’s office.

If the laboratory results are normal, the patient will have to get it again in a year. In some cases where there are no risk factors, the patients can get the PSA test every two years.

A man with prostate problems.

The incidence of prostate problems increases with age

Prostate-specific antigen or PSA

The PSA is a constituent part of the prostate exam. It consists of measuring the blood levels of a substance produced by the prostate gland. If the patient has cancer, this antigen will be elevated and this detection will alert of the disease.

However, PSA levels may also increase due to other noncancerous reasons. The following can cause elevated PSA levels:

  • A transrectal ultrasound
  • Prostatitis – prostate infections elevate PSA levels
  • Prostate enlargement – also called benign prostatic hyperplasia, this changes PSA levels, but in a less forceful way than cancer.

The standard reference values of PSA in men are less than 4 ng/mL. Between 4 and 10 ng/mL, there’s a possibility of prostate cancer. If the PSA is higher than 10, the possibility of cancer is very high.

Keep discovering in this article: Researchers Have Discovered a New Cancer Treatment that Might be Better than Chemotherapy

Digital rectal exam (DRE)

The digital rectal exam is the other constituent part of the prostate exam. The exam consists of introducing a finger into the patient’s rectum to palpate the gland.

The procedure is done with gloves and lubrication to lessen the discomfort. Medical professionals suggest that the patient lay down on the gurney and, if possible, adopt a fetal position, as they’re the less uncomfortable and painful methods.

The examiner, doctor, or nurse, seeks to palpate the prostate gland, which is close to the rectum. This exam allows them to reach it. During the palpation, the medical professional seeks to detect a lump or hardening that’s indicative of an abnormal process.

If they detect an abnormality, they’ll require more studies. Even more so if it’s combined with an elevated PSA result.

A man at a doctor's checkup.

Keep reading: What Are the Treatments for Benign Prostatic Hyperplasia?

What to do after an abnormal prostate exam

The next step to an abnormal prostate exam is imaging studies to clarify the diagnosis. The doctor may request ultrasounds and, if necessary, a biopsy of the gland.

Early detection is essential. If it’s detected very early, this tumor is completely treatable and manageable. Health professionals insist on getting a prostate exam due to its effectiveness when it comes to reducing fatal cases of prostate cancer.

It’s essential for men to lose their fear and get this test when indicated. An annual checkup can add many years to their life.

  • Pow-Sang, Mariela, et al. “Cáncer de próstata en Latinoamérica.” Actas urológicas españolas 33.10 (2009): 1057-1061.
  • González Vidal, Elsie, et al. “Índice PSA libre/PSA total: una herramienta para la detección precoz del cáncer de próstata.” Revista Archivo Médico de Camagüey 11.6 (2007): 0-0.
  • Torres, Patricia Erazo. “Ecografía transrectal y cáncer de próstata.” Acta Médica del Centro 9.3 (2015): 61-64.