Prostate Cancer

Lesson 1: Prostate Basics

Prostate Basics, the Digital Rectal Examination, and Screening Guidelines

Inside and Around the Prostate: The prostate is about the size of a walnut and, when the man is standing, is located in front of the rectum, behind the base of the penis, and under the bladder. It is a gland found only in men and produces some of the seminal fluid, which protects and nourishes sperm cells. The prostate surrounds the upper part of the urethra, the tube that carries urine and semen out of the penis. (National Comprehensive Cancer Network)

In men under 40 years old, the prostate rarely causes problems. However, men 40 and over are more likely than their younger counterparts to develop problems with their prostate. Approximately one in ten men will develop Prostate Cancer. Other non-cancerous conditions of the prostate, such as prostatitis (an inflammation of the prostate) and BPH (benign prostatic hyperplasia), which is an enlargement of the prostate, can cause complications such as difficulty when urinating. Yearly prostate examinations are of great importance for men over 40.

The digital rectal examination is the most common screening procedure to detect changes in the prostate. The exam is relatively painless, but certainly a bit annoying: your doctor or health care practitioner inserts a gloved finger into your rectum, and is able to feel your prostate through the wall of the rectum. This procedure allows your practitioner to feel for any changes in your prostate, such as enlargement, lumps, or hardened areas. The exam takes just a minute or two, and is an important part of a thorough physical examination. Many men hate this exam with a passion. If you are one of those I suggest you get over it as you will be getting the finger on a regular base over the next few years. It is an important aspect of keeping you alive.

Current recommendations call for annual prostate examinations in men aged 50 and over with a life expectancy of at least 10 years, men 40 years and over who are at high risk for Prostate Cancer, or if urinary difficulties are present. High-risk populations include men of African descent, and men with a close relative who has been diagnosed with Prostate Cancer. If there is more than one close relative diagnosed with Prostate Cancer, the risk is even greater.

In addition to the digital rectal exam, the PSA test is another diagnostic tool used to detect changes in the prostate. The PSA will be discussed in the next section of this lesson.

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