erectile
Erectile Dysfunction
Erectile dysfunction (ED) is a common type of male sexual dysfunction. It is when a man has trouble getting or keeping an erection. ED becomes more common as you get older. But it's not a natural part of aging.
Some people have trouble speaking with their doctors about sex. But if you have ED, you should tell your doctor. ED can be a sign of health problems. It may mean your blood vessels are clogged. It may mean you have nerve damage from diabetes. If you don't see your doctor, these problems will go untreated.
Your doctor can offer several new treatments for ED. For many men, the answer is as simple as taking a pill. Getting more exercise, losing weight, or stopping smoking may also help.
NIH: National Institute of Diabetes and Digestive and Kidney Diseases
Atherosclerosis
What is atherosclerosis?
Atherosclerosis is a condition in which plaque builds up inside your arteries. Plaque is a sticky substance made up of cholesterol, fat, blood cells, calcium, and other substances found in the blood. Over time, plaque hardens and causes your arteries to narrow. That limits the flow of oxygen-rich blood to your body.
Some people may confuse atherosclerosis and arteriosclerosis, but they are not the same thing:
- Arteriosclerosis is hardening of the arteries, which means that the arteries thicken and become less flexible. It can have several different causes.
- Atherosclerosis, which develops from plaque buildup, is a common type of arteriosclerosis.
Atherosclerosis can affect most of the arteries in the body. It has different names, based on which arteries are affected:
- Coronary artery disease (CAD) is plaque buildup in the arteries of your heart.
- Peripheral artery disease (PAD) is plaque buildup in the arteries that carry blood away from the heart to other parts of the body. It most often affects the arteries of your legs, but it can also affect the arteries of your arms or pelvis.
- Carotid artery disease is plaque buildup in the neck arteries. It reduces blood flow to the brain.
- Renal artery stenosis is plaque buildup in the arteries that supply blood to your kidneys.
- Vertebral artery disease is plaque buildup in the arteries that supply blood to the back of your brain.
- Mesenteric artery ischemia is plaque buildup in the arteries that supply your intestines with blood.
What causes atherosclerosis?
Plaque often starts to build up during childhood and gets worse with age. The exact cause is unknown, but researchers believe that this buildup happens when there is damage to the arteries. This damage may be caused by unhealthy lifestyle habits, medical conditions, and your genes.
Who is more likely to develop atherosclerosis?
You may be more likely to develop atherosclerosis if you:
- Have certain medical conditions, including:
- High blood pressure
- High blood cholesterol
- Diabetes
- Metabolic syndrome
- Inflammatory diseases such as rheumatoid arthritis and psoriasis
- Have a family history of high blood cholesterol
- Eat a lot of foods high in saturated fats
- Smoke or chew tobacco
- Are older - the risk increases after age 45 men and age 55 in women
What are the symptoms of atherosclerosis?
In the early stages, atherosclerosis often does not cause any symptoms. You may first notice some symptoms at times when your body needs more oxygen. For example, this could be when you are having physical or emotional stress.
Your symptoms will depend on which arteries are affected and how much blood flow is blocked:
- With coronary artery disease, the symptoms may include angina (a type of chest pain), palpitations (racing or pounding heart), and shortness of breath.
- With carotid artery disease, you may have a bruit. This is a whooshing sound that your health care provider hears when using a stethoscope. You could also have a transient ischemic attack (TIA), sometimes called a mini-stroke.
- With peripheral artery disease, you may have pain, aching, heaviness, or cramping in the legs when walking or climbing stairs.
- With vertebral artery disease, you may have problems with thinking and memory, weakness or numbness on one side of the body or face, and vision trouble. You could also have a transient ischemic attack.
- With mesenteric artery ischemia, the symptoms can include severe pain after meals, weight loss, and diarrhea.
For men, erectile dysfunction (ED) is an early warning sign that you may be at higher risk for atherosclerosis and its complications. If you have ED, talk with your provider about your risk of plaque buildup.
What other problems can atherosclerosis cause?
Atherosclerosis can cause other health problems, or complications. For example, if a plaque bursts, a blood clot may form. The clot could block the artery completely or travel to another part of the body. Other possible complications can vary, depending on which arteries are affected. For example, blockages in different parts of the body can lead to complications such as a heart attack, stroke, vascular dementia, or limb loss.
How is atherosclerosis diagnosed?
To find out if you have atherosclerosis, your provider:
- Will ask about your medical and family health history
- Will ask about your lifestyle and risk factors for plaque buildup in the arteries
- Will do a physical exam, which will include listening to your heart and the blood flow in your arteries
- Will likely order tests, such as blood tests and heart health tests
What are the treatments for atherosclerosis?
If you have atherosclerosis, your provider will work with you to create a treatment plan that works for you. Your plan will depend on which arteries are affected, how much the blood flow is blocked, and what other medical conditions you have. Possible treatments may include:
- Heart-healthy lifestyle changes.
- Medicines to:
- Manage your risk factors.
- Treat atherosclerosis or its complications.
- Treat any medical conditions you have that can worsen plaque buildup.
- Procedures or surgeries to treat diseases or complications that were caused by plaque buildup. The specific type of procedure or surgery will depend on which arteries are affected.
- Cardiac rehabilitation, if you have had certain complications from atherosclerosis.
Can atherosclerosis be prevented?
There are steps you can take to try to prevent atherosclerosis:
- Choose heart-healthy foods, such fruits, vegetables, and whole grains. Limit foods that are high in saturated fats, salt, and added sugars.
- Do regular physical activity. But before you start an exercise program, ask your provider what level of physical activity is right for you.
- Aim for a healthy weight.
- Limit how much alcohol you drink. Drinking less is better for health than drinking more. Men should limit their intake to 2 drinks or less in a day. Women should drink 1 drink or less per day.
- Manage stress.
- If you smoke, quit smoking.
- Avoid secondhand smoke.
- Get enough good-quality sleep.
NIH: National Heart, Lung, and Blood Institute
Autonomic Nervous System Disorders
Your autonomic nervous system is the part of your nervous system that controls involuntary actions, such as the beating of your heart and the widening or narrowing of your blood vessels. When something goes wrong in this system, it can cause serious problems, including:
- Blood pressure problems
- Heart problems
- Trouble with breathing and swallowing
- Erectile dysfunction in men
Autonomic nervous system disorders can occur alone or as the result of another disease, such as Parkinson's disease, alcoholism and diabetes. Problems can affect either part of the system, as in complex regional pain syndromes, or all of the system. Some types are temporary, but many worsen over time. When they affect your breathing or heart function, these disorders can be life-threatening.
Some autonomic nervous system disorders get better when an underlying disease is treated. Often, however, there is no cure. In that case, the goal of treatment is to improve symptoms.
NIH: National Institute of Neurological Disorders and Stroke
Benefits of Exercise
We have all heard it many times before -- regular exercise is good for you, and it can help you manage your weight. But if you are like many Americans, you are busy, you sit most of the day at your job, and you haven't yet changed your exercise habits. The good news is that it's never too late to start. You can start slowly, and find ways to fit more physical activity into your life. To get the most benefit, you should try to get the recommended amount of physical activity for your age. If you can do that, the payoff is that you will feel better, may help prevent or control many diseases, and will likely even live longer.
What are the health benefits of exercise?
Regular exercise and physical activity may:
- Help you get to and stay at a healthy weight. Along with diet, exercise plays an important role in maintaining a healthy weight and preventing obesity. If you are at a healthy weight, you can maintain it if the calories you eat and drink are equal to the amount of energy you burn. To lose weight, you need to use more calories than you eat and drink.
- Reduce your risk of heart diseases. Exercise strengthens your heart and improves your circulation. The increased blood flow raises the oxygen levels in your body. This helps lower your risk of heart diseases such as coronary artery disease and heart attack. Regular exercise can also lower high blood pressure, cholesterol, and triglyceride levels, all of which are risk factors for heart disease.
- Help your body manage blood glucose (blood sugar) and insulin levels. Exercise can lower your blood glucose levels and help your insulin work better. This can reduce your risk of metabolic syndrome and type 2 diabetes. And if you already have one of these diseases, exercise can help you to manage it.
- Help you manage a chronic health condition. For example, regular physical activity may help reduce pain and improve function in adults with arthritis. It can also help support daily living activities for people with disabilities. This may help them to be more independent.
- Help you quit smoking. Exercise may make it easier to quit smoking by reducing your cravings and withdrawal symptoms. It can also help limit the weight you might gain when you stop smoking.
- Improve your mental health and mood. During exercise, your body releases chemicals that can improve your mood and make you feel more relaxed. This can help you deal with stress, manage anxiety, and reduce your risk of depression.
- Help keep your thinking, learning, and judgment skills sharp as you age. Exercise stimulates your body to release proteins and other chemicals that improve the structure and function of your brain.
- Strengthen your bones and muscles. Regular exercise can help kids and teens build strong bones. Later in life, it can also slow the loss of bone density that comes with age. Doing muscle-strengthening activities can help you increase or maintain your muscle mass and strength.
- Reduce your risk of some cancers, including colon, breast, uterine, bladder, esophageal, kidney, stomach, and lung cancer. There are different ways that physical activity may lower the risk of these cancers. For example, it can strengthen your immune system and reduce inflammation in your body. It also helps prevent obesity, which is a risk factor for many cancers.
- Reduce your risk of falls. For older adults, doing balance and muscle-strengthening activities can help reduce your risk of falling.
- Improve your sleep. Exercise can help you to fall asleep faster and stay asleep longer.
- Improve your sexual health. Regular exercise may lower the risk of erectile dysfunction (ED) in men. For those who already have ED, exercise may help improve their sexual function. In women, exercise may increase sexual arousal.
- Increase your chances of living longer. Studies show that physical activity can reduce your risk of dying early from the leading causes of death, like heart disease and certain cancers.
How can I make exercise a part of my regular routine?
Here are some tips to help you make exercise part of your regular routine:
- Make everyday activities more active. Even small changes can help. You can take the stairs instead of the elevator. Walk down the hall to a coworker's office instead of sending an email. Wash the car yourself. Park further away from your destination.
- Be active with friends and family. Having a workout partner may make you more likely to enjoy exercise. You can also plan social activities that involve exercise. You might also consider joining an exercise group or class, such as a dance class, hiking club, or volleyball team.
- Keep track of your progress. Keeping a log of your activity or using a fitness tracker may help you set goals and stay motivated.
- Make exercise more fun. Try listening to music or watching TV while you exercise. Also, mix things up a little bit - if you stick with just one type of exercise, you might get bored. Try doing a combination of activities.
- Find activities that you can do even when the weather is bad. You can walk in a mall, climb stairs, or work out in a gym even if the weather stops you from exercising outside.
- Remember that some physical activity is better than none. Do what you can! Even 5 minutes of physical activity has real health benefits.
Diabetes Complications
What is diabetes?
If you have diabetes, your blood glucose, or blood sugar, levels are too high. Glucose comes from the foods you eat. A hormone called insulin helps the glucose get into your cells to give them energy.
With type 1 diabetes, your body does not make insulin. With type 2 diabetes, your body does not make or use insulin well. Without enough insulin, the glucose stays in your blood.
What health problems can diabetes cause?
Over time, having too much glucose in your blood can cause complications, including:
- Eye disease, due to changes in fluid levels, swelling in the tissues, and damage to the blood vessels in the eyes.
- Foot problems, caused by damage to the nerves and reduced blood flow to your feet.
- Gum disease and other dental problems, because a high amount of glucose in your saliva helps harmful bacteria grow in your mouth. The bacteria combine with food to form a soft, sticky film called plaque. Plaque also comes from eating foods that contain sugars or starches. Some types of plaque cause gum disease and bad breath. Other types cause tooth decay and cavities.
- Heart disease and stroke, caused by damage to your blood vessels and the nerves that control your heart and blood vessels.
- Kidney disease, due to damage to the blood vessels in your kidneys. Many people with diabetes develop high blood pressure. That can also damage your kidneys.
- Nerve problems (diabetic neuropathy), caused by damage to the nerves and the small blood vessels that nourish your nerves with oxygen and nutrients.
- Sexual and bladder problems, caused by damage to the nerves and reduced blood flow in the genitals and bladder.
- Skin conditions, some of which are caused by changes in the small blood vessels and reduced circulation. People with diabetes are also more likely to have infections, including skin infections.
What other problems can people with diabetes have?
If you have diabetes, you need to watch out for blood glucose levels that are too high (hyperglycemia) or too low for you (hypoglycemia). These can happen quickly and can become dangerous. Some of the causes include having another illness or infection and certain medicines. They can also happen if you don't get the right amount of diabetes medicines. To try to prevent these problems, make sure to take your diabetes medicines correctly, follow your diabetic diet, and check your blood glucose regularly.
NIH: National Institute of Diabetes and Digestive and Kidney Diseases
Enlarged Prostate (BPH)
What is the prostate?
The prostate is a gland in the male reproductive system. It lies just below the bladder. It makes fluid that is part of semen.
What is an enlarged prostate (BPH)?
An enlarged prostate is when your prostate gland becomes larger than normal. It's also called benign prostatic hyperplasia or BPH for short. Benign means not cancer. And hyperplasia means too much cell growth. BPH isn't cancer and it doesn't increase your risk of getting prostate cancer.
Usually, the prostate gland continues to grow during adult life. That's why BPH is the most common prostate condition in people over age 50. As the prostate gets bigger, it may press against the bladder and pinch the urethra. This can slow or block the flow of urine out of your bladder.
Over time, the bladder muscle may become weak from trying to pass urine through a narrow urethra. When this happens, your bladder may not empty completely when you urinate. A narrowed urethra and weak bladder cause many of the urinary problems you may have with BPH.
What causes an enlarged prostate (BPH)?
Researchers aren't sure why the prostate keeps growing. Some researchers think changes in hormones with aging may cause the prostate to get bigger.
Who is more likely to develop BPH?
You're more likely to develop BPH if you:
- Are age 40 or older. The chance of getting BPH increases as you get older.
- Have family members who have had BPH.
- Have certain health conditions such as:
- Obesity.
- Heart disease and problems with blood circulation.
- Type 2 diabetes.
- Erectile dysfunction.
- Don't get enough physical activity.
What are the symptoms of BPH?
Symptoms of BPH include:
- Having a frequent or urgent need to urinate
- Waking up many times to urinate
- Having problems with urine flow, such as:
- Trouble starting to urinate
- A stream that's weak, slow, or stops and starts
- Dribbling after urination
- Urinary incontinence
- Feeling that you can't completely empty your bladder
- Pain after ejaculation or during urination
- Urine with an unusual color or smell
It's important to see your health care provider if you have any of these symptoms because they could be from a more serious health problem.
You should get medical help right away if you:
- Can't urinate at all
- Have fever and chills with urination that's painful, frequent, and urgent
- Have blood in your urine
- Have pain in your lower abdomen (belly) and urinary tract
What other problems can BPH cause?
For most people, BPH doesn't cause other problems. But BPH increases your chance of developing serious conditions, including:
- Acute urinary retention. With this condition, you suddenly can't urinate at all. This a medical emergency. Acute urinary retention is common in older males and the chance of having it increases with age. It may be triggered by:
- Taking certain over-the-counter cold or allergy medicines
- Drinking alcohol
- Cold temperatures
- Not moving enough over a long period of time
- Urinary tract infections (UTIs)
- Bladder damage and bladder stones
- Kidney damage
How is BPH diagnosed?
To find out if you have BPH, your provider will:
- Ask about your medical history. Be sure to tell your provider about all the medicines you take, because certain medicines can make BPH symptoms worse.
- Ask about your family health history.
- Examine you. The exam may include a digital rectal exam (DRE) of your prostate. In a DRE, your provider inserts a gloved finger into your rectum to check if your prostate is large, tender, or irregular in any other way.
- Order medical tests, if needed, such as:
- Urine tests.
- A PSA blood test (prostate-specific antigen test).
- Urodynamic testing to see how well you can hold and release urine.
- Cystoscopy to look inside your urethra and bladder.
- Ultrasound pictures of your prostate and urinary tract.
- A prostate biopsy to diagnose or rule out prostate cancer.
What are the treatments for BPH?
Not everyone needs treatment for BPH. Treatment options depend on how much your symptoms bother you, your health, age, and the size of your prostate:
Lifestyle changes may improve mild symptoms. They include:
- Drinking less before bedtime or going out
- Avoiding or cutting back on beverages with caffeine and alcohol
- Bladder training and exercising the muscles that control urine flow
- Preventing or treating constipation
Medicines can help mild to moderate symptoms by:
- Stopping the prostate from growing
- Shrinking the prostate
- Relaxing muscles to improve urine flow
Sometimes combining 2 types of medicine helps more than taking just one type of medicine.
Medical procedures can help improve moderate to severe BPH symptoms when medicines don't help enough. There are several different types of procedures. They all use an instrument inserted into the urethra to either:
- Widen the urethra
- Destroy part of the prostate with heat
Surgery may be helpful when symptoms are severe, other treatments haven't helped, or you have another problem, such as bladder damage. Different types of surgery are used to:
- Remove part or all of the prostate
- Make cuts in the prostate to take pressure off the urethra
Most BPH surgery is done with tools inserted into the urethra.
Your provider can explain the possible benefits and side effects of your treatment options so you can decide what's best for you.
Can BPH be prevented?
Researchers haven't found ways to prevent BPH. You can take care of your prostate health by:
- Talking with your provider about your risk for developing an enlarged prostate
- Getting regular checkups
- Paying attention to your symptoms so you can get treatment early if you see signs of BPH
NIH: National Institute of Diabetes and Digestive and Kidney Diseases
Penis Disorders
Problems with the penis can cause pain and affect a man's sexual function and fertility.
Penis disorders include:
- Erectile dysfunction - inability to get or keep an
erection
- Priapism - a painful erection that does not go away
- Peyronie's disease - bending of the penis during an erection due to a hard lump
called a plaque
- Balanitis - inflammation of the skin covering the head of the penis, most often in
men and boys who have not been circumcised
- Penile cancer - a rare form of cancer, highly curable when caught early
Peripheral Arterial Disease
Peripheral arterial disease (PAD) happens when there is a narrowing of the blood vessels outside of your heart. The cause of PAD is atherosclerosis. This happens when plaque builds up on the walls of the arteries that supply blood to the arms and legs. Plaque is a substance made up of fat and cholesterol. It causes the arteries to narrow or become blocked. This can reduce or stop blood flow, usually to the legs. If severe enough, blocked blood flow can cause tissue death and can sometimes lead to amputation of the foot or leg.
The main risk factor for PAD is smoking. Other risk factors include older age and diseases like diabetes, high blood cholesterol, high blood pressure, heart disease, and stroke.
Many people who have PAD don't have any symptoms. If you have symptoms, they may include:
- Pain, numbness, achiness, or heaviness in the leg muscles. This happens when walking or climbing stairs.
- Weak or absent pulses in the legs or feet
- Sores or wounds on the toes, feet, or legs that heal slowly, poorly, or not at all
- A pale or bluish color to the skin
- A lower temperature in one leg than the other leg
- Poor nail growth on the toes and decreased hair growth on the legs
- Erectile dysfunction, especially among men who have diabetes
PAD can increase your risk of heart attack, stroke, and transient ischemic attack.
Doctors diagnose PAD with a physical exam and heart and imaging tests. Treatments include lifestyle changes, medicines, and sometimes surgery. Lifestyle changes include dietary changes, exercise, and efforts to lower high cholesterol levels and high blood pressure.
NIH: National Heart, Lung, and Blood Institute
Prostate Cancer
What is prostate cancer?
Cancer is a disease in which cells in the body grow out of control. Prostate cancer begins in the cells of the prostate. The prostate is a gland in the male reproductive system. It lies just below the bladder. It makes fluid that is part of semen.
Prostate cancer is one of the most common types of cancer. It often grows very slowly. If it does not spread to other parts of the body, it may not cause serious problems. But sometimes prostate cancer can grow quickly and spread to other parts of the body. This kind of prostate cancer is serious.
What causes prostate cancer?
Researchers don't know for sure what causes prostate cancer. They do know that it happens when there are changes in the genetic material (DNA).
Sometimes these genetic changes are inherited, meaning that you are born with them. There are also certain genetic changes that happen during your lifetime that can raise your risk of prostate cancer. But often the exact cause of these genetic changes is unknown.
Who is more likely to develop prostate cancer?
Anyone who has a prostate can develop prostate cancer. But certain factors can make you more likely to develop it:
- Age. Your chance of developing prostate cancer increases as you get older. Prostate cancer is rare in people under age 50.
- Family health history. Your risk of prostate cancer is higher if you have a parent, sibling, or child who has or has had prostate cancer.
- Race. African Americans are more likely to get prostate cancer. They're also more likely to:
- Get prostate cancer at a younger age.
- Have more serious prostate cancer.
- Die from prostate cancer.
What are the symptoms of prostate cancer?
Prostate cancer doesn't always cause symptoms, especially at first. If it does cause symptoms, they may include:
- Problems urinating (peeing), such as:
- A urine stream that's weak, hard to start, or starts and stops
- Suddenly needing to urinate right away
- Urinating often, especially at night
- Pain or burning when urinating
- Blood in your urine or semen
- Pain in your lower back, hips, or pelvis that does not go away
- Painful ejaculation (the release of semen through the penis during orgasm)
But many of these symptoms may be from other common prostate problems that aren't cancer, such as an enlarged prostate.
You should discuss your prostate health with your health care provider if you:
- Have symptoms that could be prostate cancer
- Have a high risk for developing prostate cancer
- Had a screening test that suggests you could have prostate cancer
What are prostate tests and how is prostate cancer diagnosed?
Tests which check for prostate cancer include:
- A digital rectal exam (DRE). In this exam, your provider feels your prostate for lumps or anything unusual by inserting a lubricated, gloved finger into your rectum.
- A prostate-specific antigen (PSA) blood test. A high PSA blood level may be a sign of prostate cancer. But many other things can cause high PSA levels, too.
- Imaging tests. These tests may use ultrasound or MRI to make pictures of your prostate.
If these tests show that you might have prostate cancer, the next step is usually a prostate biopsy. A biopsy is the only way to diagnose prostate cancer.
During a biopsy, a doctor uses a hollow needle to remove some prostate tissue. The tissue is studied under a microscope to look for cancer cells.
What are the treatments for prostate cancer?
Your treatment options usually depend on your age, your general health, and how serious the cancer is. Your treatment may include one or more options:
- Observation,which is mostly used if you are older, your prostate cancer isn't likely to grow quickly, and you don't have symptoms or you have other medical conditions. Your doctor will keep checking on your cancer over time so to see whether you will need to start treatment for the cancer. There are two types of observation:
- Watchful waiting means having little or no testing. If symptoms begin or change, you will get treatment to relieve them, but not to treat the cancer.
- Active surveillance means having regular tests to see if your prostate cancer has changed. If the tests show the cancer is starting to grow or if you develop symptoms, then you will have treatment to try to cure the cancer.
- Surgery to remove your prostate gland may be an option if your cancer hasn't spread outside of your prostate.
- Radiation therapy uses high energy to kill cancer cells or prevent them from growing.
- Hormone therapy blocks cancer cells from getting the hormones they need to grow. It may include taking medicines or having surgery to remove the testicles.
- Chemotherapy uses medicines to kill cancer cells, slow their growth, or stop them from spreading. You might take the drugs by mouth, as an injection (shot), as a cream, or intravenously (by IV).
- Targeted therapy uses drugs or other substances that attack specific cancer cells. This treatment causes less harm to healthy cells than radiation therapy or chemotherapy.
- Immunotherapy helps your own immune system to fight cancer.
Can prostate cancer be prevented?
Making healthy lifestyle changes may help to prevent some prostate cancers. These changes include:
- Being at a healthy weight
- Quitting smoking
- Getting enough exercise
- Eating healthy foods
NIH: National Cancer Institute
Prostate Cancer Screening
What is cancer screening?
Cancer is a disease when the cells of the body grow out of control. Cancer screening is having tests to look for signs of cancer before you have any symptoms. By the time cancer causes symptoms, it may have already spread to other parts of your body. A screening test may help find cancer early, when it may be easier to treat.
Cancer screening only tells you whether you might have cancer. It doesn't diagnose cancer. If a screening test shows signs of cancer, you'll need to have other tests to find out if you do have cancer and how serious it may be.
What is prostate cancer screening?
Prostate cancer screening looks for signs of cancer in the prostate. The prostate is a gland in the male reproductive system. It lies just below the bladder. It makes fluid that is part of semen.
Prostate cancer is most common in people over age 50. It usually grows slowly and doesn't cause health problems. In fact, it's possible to live a long life with prostate cancer and never know you have it. But in certain cases, prostate cancer may spread to other parts of the body and can be very serious.
The goal of prostate cancer screening is to find prostate cancers that may be more likely to spread so they can be treated early.
What tests screen for prostate cancer?
Two tests are commonly used to screen for prostate cancer:
- A prostate-specific antigen test, also called a PSA blood test. PSA is a protein made by your prostate. A high level of PSA in your blood may mean you have prostate cancer, but it's not proof of cancer. That's because many other things may cause high PSA levels, including:
- Having an enlarged prostate (benign prostatic hyperplasia or BPH)
- Having other common prostate problems
- Taking certain medicines
In general, the higher your PSA, the more likely it is that you have cancer. But a low PSA blood level isn't a guarantee that you don't have cancer.
- Digital Rectal Examination (DRE). The DRE is a prostate exam. In this exam, your health care provider inserts a lubricated, gloved finger into your rectum to feel your prostate for lumps or anything unusual. A DRE can check only one side of the prostate.
A PSA test or a DRE may be able to detect prostate cancer at an early stage. But it is not clear whether early detection and treatment lower the risk of dying from prostate cancer. You should talk with your provider about the benefits and harms of prostate cancer screening.
What are the possible benefits and harms of prostate cancer screening?
The possible benefits of prostate cancer screening include:
- Finding and treating prostate cancer early before it spreads
- Getting a better sense of your prostate cancer risk (based on your PSA test)
- Peace of mind if your screening shows you're unlikely to have prostate cancer now
- The option to choose further testing and closely monitor your prostate if your screening shows you may have cancer
The possible harms of prostate cancer screening include:
- Getting a false positive result. This means that your PSA test shows you may have prostate cancer when you really don't. A false positive may lead to:
- Worry while you have more tests to look for signs of cancer.
- A prostate biopsy. In a biopsy, a doctor removes tissue from your prostate so it can be studied under a microscope to look for cancer cells. This is the only way to diagnose cancer. The possible harms of a prostate biopsy include:
- Fever
- Pain
- Blood in semen
- Urinary tract infection
- Having prostate cancer treatment that you may not have needed. Prostate cancer screening may lead to a cancer diagnosis, but it's not always clear whether the cancer is likely to grow and spread. You could have unnecessary treatment for cancer that would never have caused any health problems. And the common prostate cancer treatments may have serious, permanent complications, such as:
- Urinary incontinence
- Erectile dysfunction
- Problems controlling your bowel movements (BMs)
Should I be screened for prostate cancer?
Since there are benefits and risks to prostate screening, you should talk with your provider to decide if screening is right for you. You and your provider should consider:
- Your age. The risk of prostate cancer increases after age 50.
- Your family health history. If members of your family have had prostate cancer, your risk may be higher.
- Your race. Prostate cancer is more common in African Americans. They also have a higher risk of developing prostate cancer at a younger age and having more serious disease.
- Your general health. Are you well enough to have treatment for prostate cancer if it's found?
- What you prefer. How do you feel about the possible benefits and harms of screening, diagnosis, and treatment?
NIH: National Cancer Institute