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Assume the position!

These three little words are enough to strike fear in the hearts of grown men. However, if you've reached the age of forty-five (forty, if you're African-American) and you are at high risk for prostate cancer, or over fifty if not at risk, you've heard these words from your doctor and have done as instructed.

What on earth is your doctor looking for when he suggests you bend over? He's performing a DRE (digital rectal exam, and the "digital" here has nothing to do with numbers) and examining your prostate for lumps and bumps, or other irregularities. Why would he want to do that?

First of all, you need to know what a prostate does and where it's located.

The prostate is a three-lobed, walnut-sized gland that surrounds the urethra (the tube that carries urine) in men. It's just below the bladder and can only be felt during a rectal exam. The prostate secretes a fluid that carries sperm, called seminal fluid. It's an exocrine gland, meaning the secretions pass through ducts to the outside of the body, like sweat glands. Isn't that fascinating? (It could someday be a question on Jeopardy.)

It's easy to take the plumbing for granted, especially when it works like it's supposed to and causes you no grief. However, as men age and mature (never mind what the ex says) so does the prostate gland. Unfortunately, the symptoms of an aging prostate gland mimic those of prostate cancer, although in many cases of prostate cancer there are no symptoms.

What to do?

All is not lost. In addition to the DRE, a simple blood test can be performed called a Prostate Specific Antigen test (PSA.) The PSA is a specific protein found only in the prostate, and if the levels are up, it means there's something going on. Don't panic it could be something as simple as a prostate infection, irritation, or recent ejaculation. (Reminder: don't have a PSA done after a hot date on Saturday night.) The combination of a DRE and PSA are the most effective ways of detecting prostate cancer in men.

If you are a high-risk patient, chances are you're over sixty-five, have a family history of prostate cancer, are African-American (African Americans have the highest rate of prostate cancer) and might be ingesting a diet high in animal fat. (No more cheeseburgers!) Any one of these risk factors can affect your prostate health.

Keep in mind the PSA does have its limitations. Sometimes, there are false positive or false negative readings, and an elevated PSA doesn't always mean cancer. According to the National Cancer Institute, only twenty-five to thirty percent of men who have a biopsy due to an elevated PSA actually have prostate cancer.

An elevated PSA then, is just one tool in diagnosing this condition. Tune in for the next installment where you'll learn just what prostate cancer is and what you can do about it.

In the meantime, when the doctor says bend over, now you know what he's looking for.

You just have to take it like a man.

Learn more about this author, Annetta Ribken.
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