What is the prostate?

The prostate gland is part of the male reproductive system. When healthy, it’s about the size and shape of a walnut and weighs about one ounce. It is located between the bladder, which stores urine, and the rectum. It surrounds the urethra, the tube that carries urine from the bladder out through the tip of the penis.  The prostate’s purpose is to store and secrete fluid for semen. About 30 percent of semen is comprised of prostatic fluid.

What can go wrong?

The tricky thing with prostate problems is that often there are no outward symptoms. Inflammation, which makes urination difficult or painful, or cancer, which affects one in three men, can both become issues as men age. While the exact cause of prostate cancer is unknown, age is the biggest factor. Family history and diet, particularly men who eat large amounts of fats from red meat may face a greater risk as well.

What’s a Digital Rectal Exam?

It might be a bit uncomfortable, but a Digital Rectal Exam (DRE) is a simple way for your doctor to detect cancer in its early stages, when treatment is more successful, or determine if your prostate is enlarged. It takes less than a minute (but might seem much longer!). Typically, you will be asked to stand, face the examination table, bent over with elbows on the table. Or, you may be asked to lie on your side. He/She will insert a lubricated and gloved finger into your anus and, using a circular motion, check for hard, lumpy or abnormal areas. A healthy prostate feels firm and rubbery.

Is a Digital Rectal Exam REALLY necessary?

While not all experts agree, as a guideline all men should have a DRE beginning at age 50.  African American men or men with a family history of prostate cancer should begin earlier, about 40 or 45.  

How does a DRE differ from the PSA test?

The PSA is a blood test that screens for prostate cancer, but it sometimes misses abnormalities found during a DRE. The PSA test measures the amount of prostate specific antigens (PSA) in the blood. The gold standard of detection is still the biopsy, however, the combination of the DRE and PSA together help determine if an additional test like an ultrasound or biopsy is warranted.  

What if the doctor finds a lump?

A lump can mean an enlarged prostate, a simple infection…or about half the time… nothing at all, so don’t panic. Your physician will order more tests, like an ultrasound or biopsy, or refer you to a urologist for follow up. If and when a treatment is recommended, it’s always good to get a second opinion.