Talking about your prostate, urinary symptoms, or sexual dysfunction can be uncomfortable, but it’s essential to men’s health. The prostate is a tiny reproductive organ the size of a walnut located below a man’s urinary bladder. It’s responsible for making semen and tends to grow larger with age.

“An enlarged prostate is often called benign prostatic hyperplasia (BPH), a noncancerous condition that may affect sexual function,” says Steven Guarnaccia, MD, a urologist with Dignity Health Medical Group — Sequoia. “Its symptoms include slow urine flow, difficulty urinating, frequent or urgent need to urinate, dribbling after urination, and waking up at night to urinate.”

Prostate cancer is another common form of prostate disease. It’s the most common cancer among men in the United States after skin cancer and is often detected during a routine checkup.

Myth 1: I don’t have any symptoms, so my prostate must be fine.

The reality: Men with prostate cancer may experience symptoms differently. Some men experience painful ejaculation or difficulty urinating or urinating too often. Others don’t have symptoms at all. The bottom line is that you could have prostate issues without ever knowing it. In general, consider having your prostate checked at age 55. African Americans and those with a family history of prostate cancer may need to be screened earlier, starting at age 45. Talk to your doctor about when and how often to check your prostate.

Myth 2: A high PSA level means I have prostate cancer.

The reality: Prostate-specific antigen (PSA) is a protein made by the prostate. When there is a problem with the prostate, more PSA can be released into the body. While a high level of PSA in your blood may indicate a problem with your prostate, it doesn’t automatically imply you have cancer. A larger or tender prostate, urinary tract infections, or vigorous exercise, like riding a bike, can affect your PSA score. So, don’t panic if your PSA level is elevated. Ask your doctor what could be the cause so you can take the proper steps to correct it. Although the PSA test is the most commonly used test for prostate cancer detection, researchers are looking for new ways to detect cancer earlier and improve its treatment.

Myth 3: My PSA test was normal, so I don’t need a rectal exam.

The reality: Two types of tests look for possible signs of prostate cancer. The PSA test measures the level of PSA in the blood and is the current standard for prostate cancer detection. In some cases, though, cancer is found in men with normal PSA levels, so your doctor may also recommend a digital rectal examination (DRE). It's a simple procedure in which a doctor examines the rectum and prostate gland. If your doctor feels a lump, changes in firmness or size, or anything else out of the ordinary, more tests may be required.

Talk to your doctor about which test may be right for you. If the test or tests show that you might have cancer, your doctor will refer you to a urologist for a prostate biopsy.

Myth 4: Everyone has equal risk of getting prostate cancer.

The reality: 1 in 8 men will get prostate cancer during their lifetime. A family history of prostate cancer is another considerable risk factor. 

“Men are twice as likely to have prostate cancer when a brother or father has had the disease ,” says Dr. Guarnaccia. “The risk is much higher for men with several affected family members, especially if those relatives were diagnosed at a young age.” 

African-American men are also at an increased risk. They’re more likely to get prostate cancer than other men. They also tend to get cancer at a younger age, have more advanced disease when caught, and have a more severe type of prostate cancer than other men.

The takeaway:

The goal of prostate cancer screening is to identify and treat prostate cancer before it causes any symptoms. Your doctor may recommend a DRE and a PSA blood test to check your prostate. Men between ages 55 and 69 should discuss the pros and cons of every screening test with their provider. Make an appointment with your Dignity Health Medical Group doctor to review screening options and when or how often to have your prostate checked. Use our "Find a Doctor" tool to find a Dignity Health physician near you. 

Sources:

• How Often Should Men Have a Prostate Screening? - Center for Adult Medicine and Preventive Care Passaic, NJ (campmedicine.org)
• Should I Get Screened for Prostate Cancer? | CDC
• What Are the Symptoms of Prostate Cancer? | CDC
• Key Statistics for Prostate Cancer | Prostate Cancer Facts
• How does the prostate work? - InformedHealth.org - NCBI Bookshelf (nih.gov)
• Prostate Problems | National Institute on Aging (nih.gov)
• Prostate Cancer Screening | PSA Test | MedlinePlus
• Prostate Cancer Screening Tests
• Enlarged Prostate | BPH | Benign Prostatic Hyperplasia | MedlinePlus
• Prostate Diseases | Prostatitis | Enlarged Prostate | MedlinePlus
• African American Disparities in Low-Grade Prostate Cancer Death - NCI
• Who Is at Risk for Prostate Cancer? | CDC