Screening for prostate cancer: What do you need to know about digital rectal examination?
The digital rectal examination is a clinical examination during which the attending physician makes a series of gestures to feel the patient’s prostate at the level of his rectum. This touch is risk-free for the patient and only lasts a maximum of two minutes. During the digital rectal examination, the doctor checks the consistency, texture and volume of the surface of the prostate. He can therefore detect abnormalities such as an enlarged prostate, abnormally hard or presenting nodules. In order to deepen this examination, the doctor will refer the patient to a urologist for more precision. However, it should be kept in mind that the presence of an abnormality in the prostate is not synonymous with the existence of a prostate cancer. A complementary examination makes it possible to establish a diagnosis with certainty.
Screening for prostate cancer: what is the PSA test?
Also called Prostate Specific Antigen, PSA is a protein secreted by prostate cells. It is present in the blood but in small quantities. The PSA assay is one of the best methods for detecting prostate cancer at an early stage and in the absence of clinical signs. This is a process during which the level of PSA in the blood is assessed from a blood test. At the end of this screening, several conclusions can be drawn. When the PSA level is low, it means there is no cancer. However, the likelihood of cancer being present is not completely ruled out. Additional examinations should be carried out to confirm or refute this hypothesis. If the PSA level is high, it may be prostate cancer. Thus, arrangements will be made for the treatment of the patient. However, the rise in PSA levels may be due to a urinary tract infection, prostatitis, or an enlarged prostate. In all cases, the attending physician performs clinical examinations to confirm the results. Please note that the PSA assay should not be performed in the days following a digital rectal examination, sports activity, sexual intercourse, etc. These factors cause the PSA level to rise. It is recommended to discuss this with your attending physician before making an appointment for the screening examination.
Screening for prostate cancer: why do a prostate biopsy?
Prostate biopsy is an examination performed by a urologist when the results of rectal examination and PSA assay are inconclusive. This complementary screening method involves taking 8 to 10 pieces of prostate cells for analysis. To do this, the specialist introduces, after local anesthesia, a needle into the prostate through the wall of the rectum. This process usually takes between 10 and 20 minutes. Once the sample has been taken, the cells are observed under a microscope in order to detect the presence or absence of prostate cancer.
The biopsy of the prostate allows to establish a concrete diagnosis and to take the necessary measures for a treatment. In the event that there is no cancer, this would imply the presence of a lesion which could prove to be extremely dangerous. It should be taken care of as soon as possible. When the patient has a urinary tract infection and/or bleeding, he should inform the specialist. A urine test and a coagulation test will be carried out before the prostate biopsy to avoid complications during and after the screening examination.
What other tests are there to screen for prostate cancer?
Systematic early detection is strongly recommended by the French Association of Urology. She estimates that between the ages of 50 and 75, men should be screened for prostate cancer at least once a year. According to this same association, in the presence of risk factors such as family history, people aged 45 should also be screened. The recommended examination is the digital rectal examination associated with the PSA assay.
MRI (Magnetic Resonance Imaging) is an examination during which an endorectal probe is inserted into the rectum. As for MRS (Magnetic Resonance Spectroscopy), it involves the use of an endorectal probe to measure the level of choline and citrate in prostate cells. Additional examinations should be carried out to invalidate or confirm the results of the MRI and the MRS.
Prostate cancer is a disease very present in the ranks of males. Its early detection makes it possible to take the necessary measures to treat it effectively. Do not hesitate to remind your doctor of the screening at least once a year.