The prostate gland in healthy adult men is approximately a walnut sized organ that sits under the urinary bladder and in front of the rectum. It is important for reproduction as it produces the fluid needed for sperm to travel and survive.

According to the American Cancer Society, prostate cancer is the most common type of cancer in men other than skin cancer and the second leading cause of cancer death after lung cancer in in United States. Risk factors include age, race/ethnicity and a family history of inheriting certain gene changes.

Shanker Polsani, M.D., a Piedmont Oncology Medical Oncologist practicing at Piedmont Newton Hospital, explained that prostate cancer comes in many forms, but in general is relatively slow-growing.

“As early stage prostate cancer usually causes no symptoms, screening and early detection is the key, Dr. Polsani said. “We use the PSA (prostate–specific antigen) blood test and digital rectal examination in our routine clinical practice. This treatment approach helps detect early stage prostate cancer when treatment is more effective, with fewer side effects and has much better outcomes.”

Dr. Polsani answered these top four commonly asked questions regarding prostate exams:

1. What is a prostate exam?

During a prostate exam, a gloved, lubricated finger is inserted gently into the rectum so the nearby prostate gland can be assessed for its size, texture and the presence of nodules. In addition, a PSA blood test may be drawn. PSA is a protein found in very small amounts in the bloodstream. A "normal" PSA level takes into account many factors, including the patient's age, prostate size, medications, infections and procedures.

“Used together, the exam and PSA blood test are best practice for the early detection of prostate cancer,” Dr. Polsani said.

2. Who should get a prostate exam?

The specific age for prostate exams is determined based on each individual’s risk factors. PSA screening decisions are made on a case-by-case basis. A screening should take place at 50 years for those with an average risk and a life expectancy of at least 10 or more years. African-American men and those with a first-degree relative (father or brother) diagnosed younger than 65, should have a discussion at 45 with their physician regarding screening. Men with more than one first-degree relative who had prostate cancer at an early age should have the discussion at age 40.

“Men should have a discussion regarding benefits, risks and uncertainties of screening with their physician and make an informed decision,” Dr. Polsani said.

3. Does a prostate exam hurt?

An experienced physician can complete the actual procedure in a few seconds with minimal discomfort.

4. Why is it important to get a prostate screening?

Early prostate cancer can be asymptomatic. Detection at this stage offers the patient a chance to consider various treatment options. Detecting aggressive forms earlier results in timely, lifesaving treatment.