Over 90 Percent of What Planned Parenthood Does, Part 19: Prostate Exams for Cancer Screening

prostateWelcome to the latest installment of “Over 90 Percent of What Planned Parenthood Does,” a series on Planned Parenthood Advocates of Arizona’s blog that highlights Planned Parenthood’s diverse array of services — the ones Jon Kyl never knew about.

It’s Prostate Cancer Awareness Month. This type of cancer strikes 1 out of 5 Americans with prostates. There are two common screening tests for it — and Planned Parenthood Arizona offers both of them. The first test, and the subject of this post, is the prostate exam. The second is the prostate specific antigen (PSA) test — which has both benefits and drawbacks, and which will be the subject of a future post.

Here’s the good news/bad news: Prostate cancer is the second-leading cause of men’s cancer deaths, but it also has very high survival rates when detected and treated early — a five-year survival rate of almost 100 percent.

What’s a prostate?

A normal prostate is a one-ounce, walnut-sized gland that is part of the male reproductive system. It manufactures fluid that is mixed with sperm to create semen, which is the product of ejaculation. However, the gland can often enlarge, especially later in life. Since the prostate is nestled right in there with the bladder and the urethra, when it grows in size it can block the flow of urine (it can also cause sexual problems). An enlarged prostate, also called benign prostatic hyperplasia (BPH), can mimic the symptoms of prostate cancer — but it’s not cancer. It may be treated surgically, however.

Am I at risk for prostate cancer?

While prostate cancer is common, there are a few factors that can increase your risk even more. These include:

  • age (two-thirds of prostate cancers occur in people 65 years of age or older)
  • genetics (a family history of prostate cancer — especially if a father or brother developed prostate cancer before the age of 65)
  • being of African-American descent (prostate cancer is more common in African Americans than in Americans of other races)

What are the symptoms of prostate cancer?

Signs to watch out for include troubles with urination. Although these might just be signs of an enlarged prostate, they can also be signs of prostate cancer:

  • weak or interrupted flow of urine
  • frequent urination
  • sudden urge to urinate
  • trouble starting the flow of urine
  • trouble emptying the bladder completely
  • pain while urinating
  • blood in the urine

Other symptoms can include chronic pain in the back, hips, or pelvis; shortness of breath; fatigue; rapid heartbeat; dizziness; or pale skin caused by anemia.

What’s a prostate exam?

A prostate exam is not painful — just uncomfortable, at worst. Although the procedure itself is pretty quick, it involves a health care provider inserting a finger into the rectum to feel for lumps or other abnormalities (if it makes you feel better, the nurse or doctor wears a latex glove and uses lubricant, both for your increased safety and comfort).

If a Planned Parenthood Arizona health care provider thinks anything is amiss after performing the prostate exam, he or she can refer you to a specialist who can provide follow-up tests and, if necessary, treatment. Many prostate cancers are very slow-growing, meaning you have options if your prostate is found to be cancerous. Treatments vary: Some people monitor their condition without directly treating it, while other people prefer a more aggressive approach, which might entail surgery, chemotherapy, or radiation.

The prostate exam isn’t a perfect screening test — while it can detect abnormalities, it doesn’t definitively rule them out, either. Sometimes, these tests can miss a growing cancer, while other times, the tests might yield “false positives,” resulting in unnecessary follow-up procedures. Talking to a health care provider about false positives or false negatives is a good idea if you are concerned about your risk.

Is a prostate exam useful for detecting things other than prostate cancer?

A prostate exam is just part of the more general (and gender-neutral) digital rectal exam. There are many things that a doctor can detect by performing a digital rectal exam. Some of these conditions can affect all genders:

  • hemorrhoids
  • anal and rectal cancers
  • anal warts
  • constipation
  • incontinence
  • anal fissures
  • inflammatory bowel disease

Should I get a prostate exam?

If there’s anything wrong in that region, you might need a doctor to examine your rectal area. And, if you have symptoms of an enlarged prostate or cancer, you might consider undergoing a prostate exam no matter what your age. But what if you don’t have any symptoms — should you still seek screening, just in case? Not everyone agrees.

The American Cancer Society recommends that most men consider prostate screening starting at age 50 — after discussing the pros and cons with a health care provider. However, if you are African American or have a family history of prostate cancer before age 65, you should consider your first screening at age 45. And, if you’ve had two or more close relatives who developed prostate cancer before age 65, you should consider your first screening at age 40.

While the American Cancer Society recommends a PSA test with an optional prostate exam, the U.S. Preventive Services Task Force recommends against PSA tests, finding them to have more drawbacks than benefits — and doesn’t seem to have anything to say about prostate exams either way.

National guidelines state that the choice whether or not to perform a prostate exam should be made by a patient with a health care provider. When weighing your decision, you might consider if you are a member of any of the risk groups, or if the tests will give you peace of mind. A health care provider can help you evaluate the pros and cons.

If you’re interested in scheduling a prostate exam, contact your local Planned Parenthood Arizona health center. Additionally, our health care providers can discuss the benefits and drawbacks associated with prostate cancer screening, in order to help you make the most informed decision.