How to Check Prostate Health: A Comprehensive Guide

Medically reviewed on June 27, 2022 by Jordan Stachel, M.S., RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

• Understanding the Prostate Gland
• What Is Benign Prostatic Hyperplasia?
• What Is Prostate Cancer?
• Checking Prostate Health
• Related content

The prostate gland is a highly specialized but incredibly important organ that also happens to be vulnerable to various problems. Benign prostatic hyperplasia, or an enlarged prostate, is estimated to affect about 50 percent of men between 51 and 60. That percentage goes all the way up to 90 among men older than 80. That makes it the most common prostate problem for all men older than 50 [1].

Prostate cancer is the most common cancer among men in the United States, second only to skin cancer. Estimates suggest that about one in eight men will receive a prostate cancer diagnosis at some point in his life. About 6 in 10 men over the age of 65 are diagnosed with prostate cancer. About 1 in 41 men will die of prostate cancer, but most men who receive the diagnosis will live, especially when caught early [2].

Although these statistics can be alarming, there are ways that you can check prostate health and identify issues in the prostate before they become more serious. Learn more about how to check the prostate through our guide below.

Understanding the Prostate Gland

As integral as the prostate gland is to fertility and health, it’s a small and humble organ. About the size of a walnut on average, the prostate is in front of the rectum and below the bladder. As a gland, the prostate is involved with creating some of the fluids that go into creating semen, which nourishes and transports sperm cells [3]. Most of the seminal fluid is otherwise created in the seminal vesicles found just behind the prostate gland. The urethra is what carries the semen and urine out of the body via the penis. This tube runs through the center of the prostate gland [4].

What Is Benign Prostatic Hyperplasia?

Benign prostatic hyperplasia refers to an enlarged prostate gland. Although the prostate is about the size of a walnut in younger men, it can potentially get larger as men age. Though it’s mostly harmless, an enlarged prostate can contribute to uncomfortable or embarrassing urinary issues, and it may increase the risk of problems in the kidneys, bladder, and urinary tract. Some common symptoms include:

• A persistent or urgent need to urinate
• More instances of urinating at night
• A stream that has reduced pressure or frequently starts and stops
• Problems starting urination
• Dribbling at the end of urination
• Feeling like the bladder isn’t completely empty

BPH can typically be treated with medication or minimally invasive surgery [5].

What Is Prostate Cancer?

Prostate cancer is any cancer that originates in the cells of the prostate. Most cases of prostate cancer are adenocarcinomas. This refers to cancers that have affected the prostate’s gland cells, which are the cells responsible for producing the seminal fluid. Other types of prostate cancer are rare but include sarcomas, small cell carcinomas, and transitional cell carcinomas [4].

In its early stages, prostate cancer presents no symptoms. While some forms of prostate cancer can spread quickly and aggressively to nearby tissues, most cases of prostate cancer are slow and remain confined to the gland. Still, prostate cancers that progress can exhibit a variety of signs and symptoms, including:

• General urination problems
• Reduced pressure when urinating
• Blood in the urine and/or semen
• Erectile dysfunction
• Pain in the pelvic bone
• Unintended weight loss [6]

Some cases of prostate cancer may require minimal to no treatment. Treatment is most effective and successful when the cancer is detected early [6].

Checking Prostate Health

Part of what makes prostate issues so troublesome is that they can be hard to miss until they become more serious issues, but there are thankfully ways to check prostate health and to determine if anything is out of the ordinary.

Digital Rectal Exam

During a digital rectal exam, a healthcare provider will wear a glove and apply lube to their finger. They will then insert that finger into the rectum. The prostate is located just in front of the rectum, and a healthcare provider can feel it through the rectal wall. Cancer most often starts at the back of the prostate gland. Using their finger, a healthcare provider can feel the prostate for any bumps, hard spots, or other abnormalities that might indicate cancer or other issues [7].

Digital rectal exams can feel uncomfortable, especially if there are hemorrhoids. However, it should not be painful. If it is, tell your healthcare provider. The exam is also short, taking just a few minutes [7].

Digital rectal exams are generally not as effective or accurate as other tests, and they shouldn’t be used on their own. However, when combined with other tests, particularly prostate-specific antigen tests, they can be useful in identifying and diagnosing prostate issues.

Prostate-Specific Antigen Test

The cells in the prostate gland produce a special protein called “prostate-specific antigen” (PSA). While this antigen is primarily found in semen, some of it can be detected via the blood. By measuring PSA levels, a PSA test can potentially determine prostate problems. High PSA levels may indicate cancer as normal and cancerous cells in the prostate can produce the antigen [7].

PSA levels in the blood are measured in nanograms per milliliter of blood. Although a higher PSA level may indicate a higher risk of cancer, there is no official cutoff point to tell if a man has prostate cancer. Most experts set 4 ng/mL as the cutoff (meaning PSA levels that are 4 ng/mL or higher may indicate a cancer diagnosis). Most men who do not have prostate cancer have PSA levels below 4 ng/mL. PSA levels between 4 and 10 ng/mL suggest about a one in four chance of prostate cancer, while PSA levels above 10 ng/mL increase that chance to 50 percent [7].

However, there can be cancer with a prostate-specific antigen level lower than 4 ng/mL. Alternatively, a PSA level may be above 4 ng/mL, but there may not be cancer. Much of that has to do with all the factors that affect PSA levels. Prostate-specific antigens can increase with:

• An enlarged prostate
• Prostatitis (inflammation of the prostate gland)
• Old age
• Recent ejaculation
• Certain drugs, particularly medicines that increase testosterone levels
• Some urologic procedures

On the other hand, some things that can make PSA levels go down include:

• 5-alpha reductase inhibitors
• Some herbal mixtures and supplements
• Some long-term medications (aspirin, thiazide diuretics, statins)

Still, a PSA test is valued for its ease and accessibility as the process requires a simple blood draw that can be performed with any routine checkup. Often, the best avenue is to combine PSA tests with digital rectal exams [7].

If either of the above prostate cancer screening procedures detect abnormalities, a provider may proceed with other tests to diagnose a condition more specifically. This may involve an MRI, ultrasound, or other imaging technology to see the prostate gland. A healthcare provider may also perform a prostate biopsy, which involves collecting a small tissue sample from the prostate. The tissue can be examined for the presence of cancerous cells [8].

If you think you might have prostate issues, consult your healthcare provider. Additionally, you can learn more about the prostate specific antigen and how the prostate specific antigen test is done on our blog.

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References

1. Prostate Enlargement (Benign Prostatic Hyperplasia). NIH. URL. Accessed June 27, 2022.

2. Key Statistics for Prostate Cancer. American Cancer Society. URL. Accessed June 27, 2022.

3. Prostate cancer. Mayo Clinic. URL. Accessed June 27, 2022.

4. What Is Prostate Cancer? American Cancer Society. URL. Accessed June 27, 2022.

5. Benign prostatic hyperplasia (BPH). Mayo Clinic. URL. Accessed June 27, 2022.

6. Prostate cancer. Mayo Clinic. URL. Accessed June 27, 2022.

7. Screening Tests for Prostate Cancer. American Cancer Society. URL. Accessed June 27, 2022.

8. Prostate cancer. Mayo Clinic. URL. Accessed June 27, 2022.