We should ask ourselves the fundamental question: “Why is the prostate self-exam necessary?” Many men don’t want to visit a doctor. The digital rectal exam (DRE), may deter some men from seeking preventive care. This is based on a lot of evidence. When a clinic or hospital offers free screenings for prostate cancer, it is more common to have both the PSA and DRE. If the PSA is all that is offered, many more men will sign up.
We can offer an alternative to forcing these men to endure humiliating tests and telling them to “man up”. Even though some people are skeptical about the effectiveness of the prostate self-exams, they don’t have any other options than to make men go to their doctors to get prostate exams.
A self-exam for prostate will be more effective and valuable if men are trained on how to do them. You can watch videos on the Internet that show how doctors perform prostate exams. A number of diagrams of prostate protocol are also required so that they can understand what to expect during the self-exam.
All men are encouraged to do a monthly self-exam, especially those aged 15-35. When men are able to examine their testicles themselves, it is a sign that they are mature enough and competent enough to check their prostates.
Sometimes, men believe that a doctor inserts one finger into their prostates and then touches them directly. This perception is incorrect. Although the finger (or digit is inserted through rectum), the finger is actually located within the bowel. This is distinct and separate from the prostate gland. The doctor or patient, in the case where self-exam is performed, presses the bowel wall down to feel the posterior prostate gland under the bowel wall. The prostate is effectively protected by the wall of the colon, so any suspicious nodes or areas must be large enough to be felt through the buffer. The examiner would love to feel the prostate’s surface directly. However, he must substitute this with feeling it through the wall.
Things to Keep in Mind
Normal prostate size is about the same size as a walnut. The prostate can grow to the size of an orange. Possible causes for enlarged prostate include Benign Prostatic Hyperplasia, or hormonal imbalance (too much estradiol or dihydrotestosterone), or prostatitis. Men age and enter Andropause, which is similar to women’s menopause. Andropause is a period that lasts until the end of a man’s life. During this time, testosterone levels drop and cause estrogen imbalance.
The serum estradiol level is used to measure the men’s estrogen levels. The powerful testosterone form dihydrotestosterone can cause prostate enlargement and irritation. Clinical studies have shown that prostate cancer can be caused by elevated levels of estradiol. However, dihydrotestosterone has been proven to speed up the growth of prostate carcinoma but not cause it. Prostatitis is another reason why the prostate may be larger.
The prostate feels like the pulp of an orange cut in half. The prostate is suspicious if it feels hard against the soft pulp.
Important Points to Keep in Mind
The finger must be placed into the rectum with the palm down, index finger up and the fingernail on top. This will feel more natural, especially for the first time. You would normally hold a soap bar with your palm facing up and your fingernails pointed down. You will need to learn how to pivot your hand so that the palm faces downward and the finger nail is up. This will allow you to feel the prostate with the pad of your finger. You will feel uncomfortable for at least five times before you can insert your finger correctly.
The prostate is not round like a walnut. It presents more like the top of a heart-shaped object. The majority of men will discover they have a left and right lobes. This is the median lobe through which the ureathra passes, effectively bisecting the prostate. You will soon be able to identify which lobe is touching you and the differences between them with a bit of practice.
To perform the prostate self-exam at your home, tilt your head forward so the prostate can be felt better. Standing straight up, your prostate will point in the direction of your legs and will be harder to feel using the digital rectal exam.
You can do a thorough prostate exam yourself, rather than having it done by a family physician. You should inspect every surface of your prostate at least three more times, using different circular motions for each. You can examine your prostate in the privacy of your home for at least one minute, preferably two. You want to be able detect any cancer node (hard skin) that is the same size as a grain of rice. It will take more than one quick glance to see if you can feel suspicious nodes in your prostate.
When you go to the family doctor, the doctor will insert a finger and move it quickly over your prostate. The whole process takes three or four seconds. A cursory examination could not detect cancer that is the same size as a grain of rice. That is your goal. You want to detect prostate cancer early while it is still very small.
If you don’t want to spend the time learning how to check your prostate, do not attempt self-exams. Your health is at stake. Only trust yourself if your ability to differentiate between normal and abnormal surfaces of soft tissue, such as the prostate. You should not try to differentiate between normal and abnormal surfaces if you don’t feel confident.
Prostate Self-Exam Benefits
Patients can check their prostate more often than once a year. This allows for earlier diagnosis and treatment. You don’t have to check your prostate every year. However, you can do a quarterly check if you wish.
Second, self-examinations are a great way for men to avoid embarrassing themselves and the discomfort that comes with digital rectal exams. Men can see the doctor more often without worrying about whether they will have to submit to a DRE (or prostate check) on every visit.