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When Should You Have Your Prostate Checked?

Prostate cancer screening has become a controversial topic. You may have wondered why your doctor stopped screening you for it. Learn the pros and cons of prostate cancer screening and the risk factors associated with prostate cancer to help you decide whether or not to get screened.

By
Sanaz Majd, MD,
August 10, 2017
Episode #245

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There’s no doubt that female doctors are especially in demand. This is because women tend to search for female doctors.

But what about men? Do they tend to have a preference? I’ve heard both sides of the camp. I’d love to hear from you in your comments here or on my Facebook page.

Here's a not uncommon scenario when I see some of my brand new male patients for a physical exam:

“So do you have any concerns you wanted addressed today?”

“My wife sees you, and she actually made me come in today. Otherwise, I wouldn’t be here. I don’t like doctors.”

“When is the last time you had physical?”

“Not sure. More than 10 years ago, I’d say”

“Wow, that is quite a while. You’re not afraid of us, are you?” I say with a smile. Mind you, I’m the least intimidating-appearing physician you’ll ever meet at 5 feet tall with a petite frame.

“Well, to be honest, I’m not looking forward to that prostate exam.”

“Oh, I see. You mean the rectal exam to feel the prostate surface?”

“Yes.”

“We don’t do it anymore.”

“What?! You meant I was dreading this visit for no reason this whole time?”

“Yes.”

It astounds me that many men are still unaware of this. Not unlike women who still believe that pap smears (tests for cervical cancer) are done annually (they’re not). If that is the only reason you dread the doctor, please fear no more. “Digital Rectal Exams” (or DRE) is no longer recommended as a routine screen, and I don’t know many up-to-date primary care physicians who still choose to do them. And neither is the blood PSA level (Prostate Specific Antigen).

Why don’t we screen for prostate cancer any longer? Some of you may be wondering why your doctor didn’t say anything about it and/or why your blood work didn’t include it.  Read on for a synopsis of why this has now changed.

What is the Prostate?

The prostate is a gland only present in the male reproductive system, and functions to help produce the fluid that is released in the semen. The average normal prostate size is about the size of a golf ball. It sits right next to the rectum and below the bladder, hence causing obstruction to the urinary flow when the gland is enlarged; hence, producing such symptoms such as increased frequency and hesitancy.

With age, the prostate gland tends to enlarge for most men, and often reflects two major possibilities:

1.        Benign prostatic hypertrophy (or BPH) which is a diffuse enlargement of the gland that is benign (not cancerous), and accounts for most elevated PSA’s.

2.       Prostate cancer

I know the word “cancer” makes many of us cringe at the thought. But I’ll explain why it doesn’t typically cause doctors to blink an eye most of the time when it comes to the prostate.

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