The most recommended tests to assess the health of the prostate are a digital rectal examination and a PSA blood test, which must be ordered by a urologist and carried out every year by men over 50 years of age.
When changes are found in one of these two tests, the doctor may request others, such as calculating PSA density, PCA3 urine test, prostate resonance and biopsy, which are requested according to each man’s needs.
Whenever prostate cancer is suspected, it is recommended to consult a urologist to find out which tests to take.
Main exams
The main tests used to evaluate the prostate are:
1. Digital rectal examination
Another essential exam to evaluate the prostate is the rectal examination, carried out by the urologist in the office, during a consultation with the urologist. This exam is very quick, taking about 10 to 20 seconds and does not hurt, although it can be uncomfortable. In this exam, the urologist can assess whether there is a lump, whether the prostate appears larger or harder than it should be. Understand how the rectal examination is performed.
Preparation for rectal exam: Normally, you do not need to do any type of preparation to take this exam.
Make an appointment with the nearest urologist, using the following tool, to check the need for a rectal examination:
Taking care of your health has never been easier!
2. PSA blood test
It is carried out using a common blood test that evaluates the PSA tumor marker, which normally results in values below 2.5 ng/ml in patients up to 65 years of age and up to 4 ng/ml after 65 years of age. Therefore, when this value is increased, it may indicate problems such as inflammation, prostate infection or cancer. However, this value also increases with age and, therefore, it is important to take the laboratory reference value into account. Find out how to understand the results of the PSA exam.
Preparation for blood test: To perform the blood test, the patient is advised, in the 72 hours prior to collection, to avoid sexual intercourse, avoid cycling, horse riding or motorcycling and not perform a rectal exam, as this may alter the PSA dosage value.
3. Transrectal ultrasound
Transrectal ultrasound (or prostate ultrasound) is performed to assess the size of the gland and identify changes in its structure, being very useful in diagnosing prostate cancer even at the beginning of its development.
However, as it is an invasive exam, it does not need to be carried out every year, and is only indicated when there are changes in PSA and rectal examination, and normally the urologist takes advantage of this exam to collect the sample to perform a prostate biopsy.
Preparing for ultrasound: It may be recommended to use a laxative before the exam to empty the intestine.
4. Urine stream measurement
Urinary flowmetry is an exam requested by the urologist to assess the strength of the jet and the amount of urine in each urination, as when changes occur in the prostate the jet becomes slower and weaker, indicating changes. This exam is not performed as a specific way of diagnosing prostate cancer, but it is useful in cases of prostate cancer that have already been detected for follow-up because it helps to understand its impact on the bladder and urethra.
Preparation for flowmetry: You must have a full bladder and want to urinate, and it is important to drink at least 1 L of water before the exam, which is done with the individual urinating in a specific container connected to a computer, which records the time and volume of urine.
5. Laboratory urine test
The urologist may also order a urine test, called PCA3, which is specific to assess whether there is prostate cancer, because the test does not show other changes, such as prostatic hyperplasia. This urine test also shows the aggressiveness of the tumor, being useful for choosing the appropriate treatment.
Preparing for a urine test: Urine collection should be done immediately after the rectal exam in specialized clinics.
6. Biopsy
A prostate biopsy is performed to confirm diagnoses of changes in this gland, such as cancer or benign tumors, and it is necessary to remove a small piece of this gland to send for analysis in the laboratory. This exam is always done in conjunction with prostate ultrasound, for better visualization of the structures. See How a prostate biopsy is performed.
Preparation for prostate biopsy: It is normally necessary to take the antibiotic prescribed by the urologist for around 3 days, fast for 6 hours and take a laxative to cleanse the intestine.
How old should you be to have a prostate exam?
It is recommended to undergo diagnostic tests, such as PSA and digital rectal examination, from the age of 50, but when the man has first-degree relatives with prostate cancer, or is of African descent, it is recommended to undergo the tests from the age of 45. age. These 2 exams are basic and must be repeated once a year.
But when a man has benign prostate hyperplasia, these tests must be repeated annually, regardless of age. When the urologist finds changes in these 2 basic tests, he orders others as needed.
What can change the exam result
Exam results may change when problems such as:
- Growth of the prostate, known as a benign prostate tumor;
- Presence of bacteria in the prostate, also known as prostatitis;
- Taking medications, such as diuretics, steroids or aspirin;
- Performing medical procedures on the bladder, such as biopsy or cystoscopy, may slightly increase PSA levels.
Furthermore, with aging, PSA blood test levels may increase and not signify illness. See other causes of an enlarged prostate at: Enlarged prostate, the most common change in the prostate.
Sign up for our newsletter and stay up to date with exclusive news
that can transform your routine!
