When Should Men Start Worrying About Their Prostate?

Sep 1, 2022 | Primary Care

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 There are some routine medical exams that are just, well, unpleasant or uncomfortable. A throat swab, a cardiac stress test, a pelvic exam. For men, a prostate exam is pretty high up that list.

But as the physicians at Our Lady of the Lake Physician Group Men’s Health and Executive Wellness Center tell their patients, “We all have to do it at some point.”

Prostate cancer is consistently a leading cause of cancer in men, affecting about 1 in 8 men in their lifetime, according to the American Cancer Society. The risks increase as you get older, and most medical professionals recommend screenings between the ages of 40-45 for men who have one or more direct relatives (a father, brother or paternal uncle) who have been diagnosed with prostate cancer.

By age 50, men with an average risk of prostate cancer should start getting screened during annual physicals.

And yes, that can involve a prostate exam. But not always.

According to the Men’s Health Center’s Medical Director Curtis Chastain, MD, and Tyler Boudreaux, MD, a prostate cancer screening can be both simple and complex. “Simple in that it doesn’t take much time for the patient, but complex in that there is no one perfect test,” Dr. Boudreaux says.

During a screening, your doctor will administer a prostate-specific antigen (PSA) blood test. Your doctor may take several of these tests over time to compare the “rate of rise” in PSA levels as a clue to the likelihood of cancer.

Some things may throw the PSA results off, such as a bacterial infection or certain medications you are taking. “Only after these causes have been ruled out do we embark on the cancer conversation,” Dr. Chastain says.

The digital rectal exam (DRE) is performed so your doctor can check for any abnormalities or nodules on or around the prostate gland that might need to be biopsied. While it may be an uncomfortable experience, it usually takes only a couple of seconds to complete the exam.

Dr. Boudreaux and Dr. Chastain say regular PSA tests are especially important to help your doctor track changes over time and develop a more predictive understanding of your prostate cancer risks.

“For men 50 and older, this is an especially important time to have multiple data points on a patient’s PSA,” Dr. Boudreaux says.

When prostate cancer is in its early stages, it usually presents no symptoms or warning signs. More advanced prostate cancers can sometimes cause symptoms, such as problems with urination, blood in the urine or semen or weakness or numbness in the legs or feet.

Some additional facts about prostate cancer:

  • It’s more likely to develop in older men and in non-Hispanic Black men.
  • The average age of men at diagnosis is about 66, and 80% of men are likely to have prostate cancer by age 80.
  • While it can be a serious disease, most men diagnosed with prostate cancer will not face life-threatening symptoms.
  • Prostate cancer often grows very slowly, so with older men, their doctor might recommend ongoing observation or active surveillance to monitor for any symptoms rather than aggressively treating it.
  • No supplements have been proven to reduce the risk of prostate cancer.
  • While men’s prostate glands can get enlarged as they get older — a condition known as benign prostatic hyperplasia (BPH) that can also lead to repeated trips to the bathroom at night — there is no correlation between BPH and prostate cancer, except for that both risks increase with age.

There are several topics that come up regularly when men discuss their health issues with a doctor who listens. When to start prostate cancer screenings is a big one, and connecting with a primary care physician is the first step to ease any uncertainty or to answer questions.

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