How a Healthcare Provider Performs a Prostate Exam

Depending on your general health, your age (usually 50 years old and up), or if you are having difficulty in passing urine, your healthcare provider may advise a prostate examination. If you have no urinary symptoms but are concerned about your risk for prostate cancer, you may want to have a discussion with your healthcare provider regarding the risks and benefits of prostate cancer screening.

You may or may not be familiar with the prostate exam procedure itself, but have you ever wondered what the healthcare provider's looking for exactly?

Prostate Cancer Screening

There are two types of tests healthcare providers use to screen for prostate cancer:

1. A blood test where prostate cancer can be found early by testing the amount of prostate-specific antigen (PSA) in the blood. 
2. A digital rectal exam (DRE) (where the healthcare provider puts a gloved finger, or "digit," into the rectum to feel the prostate gland)

It is usually the DRE procedure that alarms most men. To ease your nerves here is a breakdown of what a digital rectal exam entails.

What to Expect During the Digital Rectal Exam (DRE)

Your healthcare provider may examine you either standing or lying down.

• If standing, you will be asked to stand facing the examination bed, with feet apart, body bent forward and your arms or elbows on the bed. Feel free to ask your healthcare provider to give you a heads up before making any sudden movements.
• Wearing surgical gloves, the healthcare provider will coat a finger in lubricant.
• The finger will be inserted into your rectum in a downwards angle. You may feel a little pressure or slight discomfort, but it shouldn't hurt. It is important to relax and take deep breaths and let the healthcare provider know immediately if there is pain.
• Your healthcare provider may have to wait a few seconds for your external sphincter muscle to relax, and may ask you to bear down as if you are having a bowel movement.
  The healthcare provider moves the finger in a circular motion in order to identify the lobes and groove of the prostate gland. The healthcare provider checks for:
  Lumps on or around the prostate
• Swelling 
• Tenderness
• Hard spots or bumps (the gland should be smooth) 
• Abnormalities on the prostate
• A normal prostate is usually around 2-4 cm long and has a triangular shape, with a firm and rubbery texture
• Once finished, your healthcare provider will probably tell you he is going to remove his finger. You may be offered some tissue or wipes to clean off the lubricant.
• The whole procedure should take about 5 minutes from start to finish, and there are no special precautions that need to be taken prior to the exam.

What Happens After the DRE

If any abnormalities are found during the DRE, the healthcare provider may order more tests and possibly schedule a prostate biopsy to see if there are any signs of cancer present.

If there are no signs of prostate cancer found during screening, the results of the PSA blood test may help to determine the time between future prostate cancer screenings. PSA levels vary by age and other factors.

Ultimately, you and your healthcare provider will decide how often you should be screened since your diet, health and lifestyle habits are all factors on the timing and frequency of your prostate cancer screenings. Be sure to consult with your healthcare provider if you notice any changes in your health.