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Prostate Cancer: Do You Have to Have a Rectal Exam?

There are few things that men find more petrifying than a prostate exam. The words alone suggest discomfort and embarrassment. It could be considered the male equivalent to a woman’s pap smear. Many men are reluctant to have conversations related to their prostate health with their health care professionals. Some men stay away from the clinic no matter what. But what if I told you that you could have an open discussion with your health care provider and perhaps never have to have a digital rectal exam (prostate exam)? Would it seem less scary, less daunting of a task? I hope so. So men, listen up. You can see your health care provider and discuss prostate health and prostate cancer WITHOUT having to get a prostate exam. This should be good news for many men. However, some men will still need a digital rectal exam BUT this is determined on an individual basis between you and your health care provider.

The American Cancer Society has a specific set of guidelines to be used to determine the need for prostate cancer screening. Screening for prostate cancer includes the blood test known as the prostate-specific antigen (PSA) as well as the digital rectal exam (DRE). Depending on the conversation between you and your health care provider a PSA may be ordered. Depending on the result of this test, a DRE may be recommended.

According to the American Cancer Society, screening discussions should be considered among the following populations.

  • Age 50 for men who are at average risk of prostate cancer and are expected to live at least 10 more years.

  • Age 45 for men at high risk of developing prostate cancer. This includes African Americans and men who have a first-degree relative (father, brother, or son) diagnosed with prostate cancer at an early age (younger than 65).

  • Age 40 for men at even higher risk (those with more than one first-degree relative who had prostate cancer at an early age).

Of course, if you are having symptoms of a prostate problem such as blood in your urine, pain, painful urination, or frequent urination you should discuss with your health care provider right away.

Prostate cancer is the most common cancer among men aside from skin cancer. It is also usually a very slow-growing cancer. Most prostate cancers are found early due to screening and early prostate cancer does not usually have any symptoms. More advanced prostate cancer can sometimes have symptoms such as erectile dysfunction, pain in various bones, blood in urine or semen, or loss of bladder or bowel control. However, most of these symptoms can also be caused by a more likely culprit like benign prostatic hyperplasia (BPH). BPH is a non-cancerous growth of the prostate.

Many treatments are available for prostate cancer including surgery, chemotherapy, radiation, and hormone therapy. Some men do not need any treatment at all. They only need surveillance. There is no guaranteed way to prevent prostate cancer but you can lower your risk through maintaining a healthy body weight and diet. Many of the risk factors for prostate cancer are uncontrollable such as age, race, and family history.

Because prostate cancer is so common among men, it is in everyone’s best interest to be aware and to feel comfortable discussing with your health care provider. Early intervention is key. Hopefully, knowing that a DRE may not be required will help men feel empowered regarding their health.

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Do you need to have a discussion on prostate health with your health care professional? How can loved ones support and encourage men to communicate openly and honestly with health care professionals?

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