MEN’S HEALTH: Prostate exams may be uncomfortable, but knowing you’re in the clear of cancer makes it worth it

“Prostate.”

The word, by itself, is fairly innocuous. However, when coupled with the word “exam,” it takes on cringe-worthy overtones, particularly for men — like me — over the age of 40.

In modern society, it’s difficult to find a man who doesn’t understand the importance of a regular prostate exam. It’s even more difficult to find a man who looks forward to the procedure.

There are two types of prostate exams — the PSA Blood Test and the DRE, which has nothing at all to do with the rapper, Dr. Dre. The DRE I’m talking about stands for Digital Rectal Exam, and yes, it is exactly every bit as fun as it sounds, which is to say, not at all.
Spectrum Health, which provided me with prostate information, doesn’t mention that the DRE isn’t fun, but I didn’t need some hospital to tell me that.

Now, I know there are women out there thinking, “Wimp! If you think your DRE is a big deal, you should try a visit to a gynecologist.” To which I say, this is different. I’m not sure how, exactly, but it has something to do with being a man and a lifetime spent thinking there are certain places one simply does not put one’s gloved, lubricated fingers.

But in my ongoing effort to live well past 100, I go in for my yearly appointment, dreading the whole time the moment the doctor puts on the rubber glove.

Like the PSA Blood Test, the worst of it is the anticipation, the foreknowledge of what’s coming next and the feeling that this somehow goes against the natural order of things. But the actual procedure, while never likely to be mistaken for an all-expense paid trip to Disneyland, really isn’t particularly awful.

And I have to admit, it’s comforting to know everything “south of the border” is in good working condition and functioning according to factory specs.

According to the Prostate Cancer Foundation, many men so dread the DRE (is it a coincidence that the acronym makes up the first three letters in the word “dread?”) so much that they put off a screening even when they begin exhibiting “warning signs” of prostate cancer. These include:

• A need to urinate frequently, especially at night
• Difficulty starting urination or holding back urine
• Weak or interrupted flow of urine
• Painful or burning urination
• Difficulty in having an erection
• Painful ejaculation
• Blood in urine or semen
• Frequent pain or stiffness in the lower back, hips, or upper thighs

All kidding aside, if you’re experiencing any of these things and you’re over 40, you should think about making an appointment with your doctor as soon as possible.

So far (knock on wood), my screenings have come back negative, which is to say, positive. In other words, no problems.

According to my physician, Dr. Kevin Reed, who works out of Spectrum Health Medical Group, if either the PSA or DRE turned up anything indicating a problem (knock on wood, again), the next step would likely be a biopsy or one of many supplementary tests that can be ordered. I didn’t ask him too much about the nature of these supplemental tests; if a problem ever arises (knock on wood yet a third time) I suppose I’ll find out then.

I should point out not all experts call for screening after 40; some suggest 50 as the age one should start making a prostate check part of your annual physical. Some of it depends on lifestyle and family history.

The Prostate Cancer Foundation suggests that the decision to obtain a screening be made on a case by case basis, between patient and doctor.

The foundation’s website states, “Ultimately, decisions about screening should be individualized based on a man’s level of risk, overall health and life expectancy, as well as his desire for eventual treatment if he is diagnosed with prostate cancer.”

When I asked Dr. Reed what I could do to minimize my risk of prostate trouble, he told me to lose some weight. Doctors have been telling me that for years and yet I keep going to them. It’s a mystery.

Dropping a few pounds is only one of many measures you can take to stave off prostate problems, however. Some are easier than others.

Eating more fish is easy and good for the prostate. Eating less red meat and dairy is not so easy, but is also good for you.

Not taking too many vitamins, especially mega-vitamins and calcium supplements, also helps. Personally, I hate to take vitamins, and now I have a reason not to. According to the foundation, if I’m eating a reasonably healthy diet, I don’t need vitamins anyway. I’m not sure my definition of “reasonably” is the same as theirs, but I’m going to assume it is because it gets me off the hook, vitamin-wise.

Though I’m not particularly fond of broccoli — and cauliflower looks like brains to me — I’ll go ahead and eat some of each every week, or try to. It turns out these and other “cruciferous” vegetables help keep prostate problems at bay.

I don’t smoke, which is good; in addition to all the other health problems it causes, it also causes prostate trouble, as does excessive drinking. Again, I’m going to assume the foundation’s definition of “excessive” is the same as my own, though I’m guessing it’s really not.

Other lifestyle factors that help prevent prostate cancer include getting regular exercise, eating a reasonably healthy diet and minimizing stress at work and home. I try to do those things already, so I should be good to go there.

Of course, no lifestyle change can guarantee, 100 percent, that you’ll never develop prostate problems. Your best bet, all kidding aside, especially if you’re over 50 (or, in the case of African Americans, over 40) is to get your yearly PSA and DRE, or, at the very least, discuss your options with your doctor.

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