Questions and Answers
What is the most accurate prostate cancer test? My Doctor realy doesn’t feel comfortable about digital exam.
I’m worried that due to his reluctance I’ll be diagnosed too late.
I’m 50 and having symptoms.
The common tests your doctor or nurse will perform first require no special preparation. Digital rectal exams (DRE) and blood tests for prostate-specific antigen (PSA) are often included in routine physical examinations for men over 50. For African-American men and men with a family history of prostate cancer, it is recommended that tests be given starting at age 40. Some organisations even recommend that these tests be given to all men starting at age 40. If you have urination problems or if the DRE or PSA test indicates that you might have a problem, you will probably be given additional tests that may require some preparation. Ask your doctor or nurse whether you should change your diet or fluid intake or stop taking any medications. If the tests involve inserting instruments into the urethra or rectum, you may be given antibiotics before and after the test to prevent infection.>
DRE. This exam is usually done first. Many doctors perform a DRE as part of a routine physical exam for any man over 50, some even at 40, whether the man has urinary problems or not. You may be asked to bend over a table or to lie on your side holding your knees close to your chest. The doctor slides a gloved, lubricated finger into the rectum and feels the part of the prostate that lies next to it. You may find the DRE slightly uncomfortable, but it is very brief. This exam tells the doctor whether the gland has any bumps, irregularities, soft spots, or hard spots that require additional tests. If a prostate infection is suspected, the doctor might massage the prostate during the DRE to obtain fluid for examination with a microscope.
PSA Blood Test. To rule out cancer, your doctor may recommend a PSA blood test. The amount of PSA, a protein produced by prostate cells, is often higher in the blood of men who have prostate cancer. However, an elevated level of PSA does not necessarily mean you have cancer. The Food and Drug Administration has approved a PSA test for use in conjunction with a DRE to help detect prostate cancer in men age 50 or older and for monitoring men with prostate cancer after treatment. However, much remains unknown about how to interpret the PSA test, its ability to discriminate between cancer and benign prostate conditions, and the best course of action if the PSA is high.
Because so many questions are unanswered, the relative magnitude of the test’s potential risks and benefits is unknown. When added to DRE screening, PSA enhances detection, but PSA tests are known to have relatively high false-positive rates, and they also may identify a greater number of medically insignificant tumors.
The PSA test first became available in the 1980s, and its use led to an increase in the detection of prostate cancer between 1986 and 1991. In the mid-1990s, deaths from prostate cancer began to decrease, and some observers credit PSA testing for this trend. Others, however, point out that statistical trends do not necessarily prove a cause-and-effect relationship. The benefits of prostate cancer screening are still being studied. The National Cancer Institute is conducting the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, or PLCO Trial, to determine whether certain screening tests reduce the number of deaths from these cancers. DRE and PSA exams are being studied to see whether yearly screening will decrease the risk of dying from prostate cancer.
Until a definitive answer is found, doctors and patients should weigh the benefits of PSA testing against the risks of followup diagnostic tests and cancer treatments. The procedures used to diagnose prostate cancer may cause significant side effects, including bleeding and infection. Treatment for prostate cancer often causes erectile dysfunction, or impotence, and may cause urinary incontinence.
Urinalysis. Your doctor or nurse may ask for a urine sample to test with a dipstick or to examine with a microscope. A chemically treated dipstick will change color if the urine contains nitrite, a byproduct of bacterial infection. Traces of blood in the urine may indicate that a kidney stone or infection is present, or the sample might reveal bacteria or infection-fighting white blood cells. You might be asked to urinate into two or three containers to help locate the infection site. If signs of infection appear in the first container but not in the others, the infection is likely to be in the urethra. Your doctor or nurse might ask you to urinate into the first container, then stop the stream for a prostate massage before completing the test. If urine taken after prostate massage or the prostate fluid itself contains significantly more bacteria, it is a strong sign that you have bacterial prostatitis.
Transrectal Ultrasound and Prostate Biopsy. If prostate cancer is suspected, your doctor may recommend a transrectal ultrasound. In this procedure, the doctor or technician inserts a probe slightly larger than a pen into the rectum.
Possible prostate problem?I’m a bit worried. My boyfriend pees alot during the day and night especially for the amount of liquid he drinks. He has some “sexual” issues at times but not lately really. I know prostate issues are real common and I want to take him to the doctors. I will when we get the money too but anyways…. Should we be worried?
Prostate problems only begin in much older men, so it isn’t that.It may be just the way his body works. If it isn’t causing him pain and he feels ok, just leave it.
Prostate enlargement? I have been diagnosed with prostate enlargement, what should I be doing, include medicines etc. This is a pretty common problem. I work for a urologist and the majority of his clients have some form of prostate enlargement. There are several things you can try. The best idea is to find a specialist… You can ask your primary care physician for a referral. The doctor would probably recommend drug therapy to start with. There are many options that can help reduce the tissue inflammation. Depending on your PSA level he may recommend a biopsy to rule out prostate cancer. The main goal is to have satisfaction with your urinary system. If the enlargement is causing severe symptoms such as a weak stream, urinary retention, incontinence or having to force to start urination he may recommend surgery.
There are several options there too. One procedure off hand is a procedure that requires a day or two of hospital recovery its call a “Trans Urethral Resection of the Prostate” aka TURP. Google it… You’ll get the details. There are also some minimally invasive procedures done in the office that include “microwave” and something called “PROSTIVA” both are designed to prevent further inflamation and swelling. Conservative managment is always best so if the drugs work stick with that but if there is a significant alteration in your quality of life seek other options. I would definatly recommend seeing a specialist if you are having symptoms.