Prostate Exams and Medicare: Causes, Symptoms, & Risk Factors

Prostate Exams

With the exception of skin cancer, men are diagnosed with prostate cancer more than any other type of cancer. The American Cancer Society estimates that nearly 165,000 men will receive a prostate cancer diagnosis this year. What’s more, one in nine men are diagnosed over their lifetime. September is Prostate Cancer Awareness Month. Activists use this time to educate people about the risks and symptoms of prostate cancer to aid in early diagnosis. When it comes to all types of cancer, early diagnosis is critical to improving survival rates.

What Is Prostate Cancer?

When cells in your body grow out of control, cancer may develop. This may happen in just about any part of your body. When it happens in the prostate, the result is prostate cancer.

The most common type of prostate cancer by a substantial margin is called adenocarcinomas. Most prostate cancers grow slowly and often don’t spread beyond the prostate gland. However, the cancer may be more aggressive, growing and/or spreading quickly. Early detection is a key component of successful treatment.

Prostate cancer is highly treatable and boasts excellent survival rates. The majority of diagnoses occur after age 65. Prostate cancer rarely strikes men before they turn 40, with the average age of diagnosis coming in at 66.

Prostate exams

Prostate Cancer Causes and Risk Factors

Although researchers know that prostate cancer cells are genetically different from healthy prostate cells, they don’t yet know why this happens. Your DNA effects more than whether your hair is brown and your eyes are blue. It also controls the growth and lifespan of your body’s cells.

Researchers are still trying to figure out why some genes make you more or less likely to develop cancer. They have, however, determined certain risk factors that indicate whether you’re more likely to develop prostate cancer. The first is age, as prostate cancer is more common in men over the age of 60.

Race also plays a role, with African American men being more likely to receive a prostate cancer diagnosis than men of any other race. African Americans are also more likely to have a more aggressive form of the disease.

If you have a family history of prostate cancer, you may have a higher risk of prostate cancer. Your risk may also be higher if your genetic makeup includes the genes that increase the risk of breast cancer or if there’s a family history of breast cancer.

Finally, obese men are more likely to have an advanced form of prostate cancer or one that’s more difficult to treat.

Prostate Cancer Symptoms

During the early stages of the disease, men typically experience few symptoms. If the disease is more advanced, common symptoms include:

  • Urination issues, including a weak stream or increased frequency, particularly at night
  • Blood in urine or semen
  • Erectile dysfunction
  • Loss of bladder or bowel control due to the prostate pressing on the spinal cord
  • Numbness or weakness in the legs and feet
  • Pain in the bones, particularly back, chest, and hips, which indicates the cancer has spread

It’s important to note that experiencing these issues is more often due to non-cancerous conditions. For example, a non-cancerous growth known as benign prostatic hyperplasia is a much more common reason men have difficulty urinating. That said, do not hesitate to tell your doctor if you experience any of these symptoms. Even if the cause is not cancer, you want to address and treat the underlying issue.

Prostate exams

Prostate Cancer Screening Tests

The most common prostate screening test is the digital rectal exam (DRE). If you’ve seen a sitcom in the past 30 years, you’ve heard a joke about the DRE. For this test, your physician inserts a gloved, lubricated finger into your rectum. This is how your doctor examines the prostate. If the DRE reveals any abnormalities as to shape or size of the prostate, your doctor may order a prostate-specific antigen (PSA) or transrectal ultrasound (TRUS).

For the PSA test, your doctor orders bloodwork. The lab looks for PSA, which is commonly found in trace amounts in your blood. However, if PSA levels are high, this may indicate an issue with your prostate.

If both your PSA and DRE results are abnormal, you may need a TRUS. This test allows your doctor to look more closely at your prostate. It may also be used to guide a biopsy procedure if required. These tests help diagnose prostate cancer early.

There are numerous treatment options if testing results in a diagnosis of prostate cancer. The course you and your doctor decide to take depends entirely on your unique circumstances.

Medicare Coverage for Prostate Cancer Screenings

If you have Medicare Part B and are a male over the age of 50, Medicare covers yearly DRE and PSA tests.

Medicare Part A covers inpatient hospital treatment for prostate cancer. Medicare Part B covers outpatient treatment and services, including doctor visits and screenings. Co-insurance and deductibles apply.

If your doctor accepts assignment, you have the standard 20 percent co-insurance for the DRE. However, the PSA test is typically free, although you may have costs related to the screening. Talk to your doctor to be sure. As always, if you have a Medicare Advantage plan, you get all of the same benefits as those who have Original Medicare.

If you have any questions about your Medicare Advantage plan or your Medigap coverage, call us toll-free at 844-655-4347. One of our licensed agents will answer any questions you have.