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The Prostate Check
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The first step in any medical checkup is a thorough medical
history, including a family history. Your doctor will ask you questions
about any past problems, treatments, or medical procedures and about any
symptoms you are having, particularly problems with urination.
Early diagnosis of prostate cancer increases the chance of a
cure. |
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Examination |
A
physical examination is the second step. The prostate is an internal organ, so
the physician cannot look
at it directly. However, the doctor can feel the
prostate by inserting a gloved, lubricated finger into the rectum.
This simple
procedure is called a digital rectal examination (DRE). This necessary
examination allows the
physician to estimate whether the prostate is enlarged or
has lumps or areas of abnormal texture. While this
examination may produce
momentary discomfort, it causes neither damage nor severe pain. If the results
of
the digital rectal examination suggest that you may have a significant
prostate problem, your doctor may refer
you to a urologist. This is a doctor who
specializes in diseases of the urinary tract and male reproductive system.
The
urologist may perform additional tests, including blood tests, urine tests, and/
or other diagnostic procedures,
to determine the nature of your prostate
problem.
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When examining the prostate, your physician
inserts his/her forefinger (wearing a
lubricated glove) and presses gently on the
lower wall of the rectum. |
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The PSA
Blood Test |
The PSA test detects the level of prostate specific antigen in the blood. PSA is
a protein originally found in semen,
the fluid that carries sperm. Normally, PSA
is made in the epithelial cells of the prostate, which produce some of the
semen
that comes out of the penis at the time of sexual climax (orgasm). PSA is only
made by prostate cells.
Small amounts of the protein get into the circulatory
system and can be measured in the blood. Certain prostate
conditions, including
cancer, can cause high levels of PSA in the blood. Once a small blood sample is
taken, the
level of PSA is measured by an accurate laboratory method called an
immunoassay. Many factors can cause the
PSA to rise, but PSA itself is harmless.
The PSA blood test is used, along with the DRE, to find men who may
need further
testing. PSA cannot diagnose prostate cancer, however, only a biopsy can do
that. The PSA test also
is used to track the progress of men being treated for
prostate cancer. If treatment is effective, the PSA should remain
in the normal
range. Improved methods of PSA testing are being developed. In the future, these
may help your urologist
decide whether the rise in PSA is due to
prostate cancer or to a less serious problem.
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