What Is a Prostate Exam: 7 Things Men Should Know

If you haven’t had a prostate exam before, the prospect can be a little daunting. But when should you get a prostate exam? And what can you expect?

In this blog, we’ll answer some of the most common questions we receive about the process. 

What is the prostate?

The prostate is a small gland about the size of a walnut. It sits underneath the bladder in men. The prostate plays an important role in reproduction as it produces fluid that nourishes and protects sperm. When a man ejaculates, the prostate releases some of this fluid, which mixes with sperm from the testes to produce semen. 

What is a prostate exam?

A prostate exam is used to screen men for early signs of prostate cancer.

Prostate cancer happens when the cells in the prostate start to multiply uncontrollably. Symptoms of prostate cancer do not usually appear until a mass has grown, which is large enough to affect the urethra (the tube that carries urine from the bladder, through the prostate, and out the penis). One reason for this is the way cancer grows. You’ll usually only get early symptoms if the cancer grows near the urethra and presses against it, affecting how you wee. Normally though, prostate cancer starts to grow in the outer part of the prostate, which means that it won’t press against the urethra and cause symptoms until later on. Prostate screening can detect the disease before symptoms appear. 

What happens during a prostate exam?

Your doctor or nurse will need to feel your prostate gland to check for any anomalies. To do this, they will insert a gloved finger into your rectum and perform a digital rectal examination (DRE) while you lie on your side with your knees hugged into your chest.

The exam can be embarrassing and uncomfortable, but it only takes around one minute to do, so will be over quickly. It doesn’t usually hurt, but some people might get the urge to wee. If the doctor finds any lumps or feels that the prostate is enlarged, they will discuss this with you straight away. 

You may be advised to have a prostate-specific antigen (PSA) test in addition to a DRE. PSA is a protein produced by the prostate gland, and normally, the higher the level of PSA in the blood, the more likely a person is to have prostate cancer.

If either, or both, the DRE and PSA test results warrant further investigation, your doctor may refer you for additional tests, such as a transrectal ultrasound scan, a biopsy, an x-ray or a PCA3 test (this is a urine sample test, which looks for the expression of genes that are only found in prostate cancer cells.)

When should you get a prostate exam?

Prostate cancer is most common in men aged 75-79 and is very rare in men under 50. Black men and those with a close relative who developed the disease before age 65 also have a higher risk of developing this type of cancer.

There is currently no screening programme for prostate cancer in the UK. However, because there are typically no symptoms until the cancer has advanced, it’s a good idea for all men over 50 to get checked. For anyone in a higher-risk group, such as black men, screening from the age of 45 is wise. 

How often should you get a prostate exam?

The frequency of testing will depend on your risk of developing prostate cancer. For example, someone who has a close relative who was diagnosed with the disease before age 65 may be advised to have an annual exam. 

Your doctor can advise you on how often to book a prostate exam.

How common is prostate cancer?

In most western countries, prostate cancer is the most common cancer in men. According to data from Prostate Cancer UK, more than 47,500 men in the UK are diagnosed with this type of cancer every year, which equates to 129 men per day. One in eight men will be diagnosed with prostate cancer in their lifetime.

Why is it important to get a prostate exam?

Prostate cancer is typically asymptomatic until it is considerably advanced. Even when symptoms appear, such as pain when urinating, men are characteristically slow to seek medical advice.

A prostate exam is the only way to detect cancer early, which is also when treatment has the highest chance of success. 

What treatments are there for prostate cancer?

Slow-growing prostate cancer might not actually need any treatment. Regular monitoring is often the best approach; unless the cancer begins to develop more rapidly, then interventions may be necessary. 

If you need treatment, your cancer care team will recommend the most appropriate approach, depending on the size of the cancer, what grade it is, your overall health, and whether the cancer is isolated in the prostate or has spread to other parts of the body. 

There are four main types of treatment:

• Surgery to remove the entire prostate gland;
• Radiotherapy to kill cancer cells;
• A new type of radiotherapy called brachytherapy, which aims to kill tumours from the inside; and
• Hormone therapy to halt the growth and division of cancer cells. 

If you’re interested in booking a prostate exam or are worried about any symptoms, get in touch with us today. At our Prostate Clinic in London, we have a range of specialists who can help with the full spectrum of prostate conditions.