The prostate is a gland unique to males, about the size of a chestnut. It is located at the outlet of the bladder and surrounds the urethra. Its main function is to secrete prostatic fluid, which is a component of semen. Disorders of the prostate can directly affect urinary function.
As men age, they may experience difficulties in urination, frequent urination, nocturia (waking up at night to urinate), or slow urine flow. These symptoms could be signs of prostate enlargement or even prostate cancer.
Among men aged 50 and above, half of them may have prostate enlargement issues. Therefore, it is recommended that men aged 50 or above undergo preventive examinations every 1-2 years. Men with a family history of prostate cancer or other diseases may need to undergo examinations earlier. For detailed information, it is advisable to consult a doctor.
Examinations can help prevent the following common prostate conditions in men:
- Acute and chronic prostatitis
- Prostate enlargement (benign prostatic hyperplasia)
- Prostate cancer
The examination items can be categorized into the following six types:
1. Digital Rectal Examination (DRE):
DRE is a preliminary examination for prostate cancer. During the examination, the doctor will wear gloves, apply lubrication, and insert a finger into the rectum to check for any abnormalities in the prostate near the rectum. If there are cancer cells, the texture is usually harder or nodular, and the shape may be asymmetric. Tumors larger than 0.2 ml can be detected during the digital rectal examination. If any abnormalities are found, the doctor will arrange further tests.
2. Prostate-Specific Antigen (PSA) Test
The PSA test is used to detect the levels of Prostate Specific Antigen, a protein produced by the prostate gland, in the blood. Generally, higher PSA levels indicate a higher risk of prostate cancer. However, it is important to note that other urinary system problems such as benign prostatic hyperplasia, urethritis, or recent activities such as digital rectal examination or ejaculation can also cause elevated PSA levels. Therefore, PSA levels alone cannot be used as a definitive diagnosis for prostate cancer.
3. Ultrasound Examination
Ultrasound examinations aim to visualize the prostate and determine whether it is benign prostatic hyperplasia or prostate cancer. There are two types of ultrasound examinations:
- Transrectal/Prostate Ultrasound
- The ultrasound probe is inserted into the rectum to visualize and measure the size of the prostate.
- Bladder Ultrasound
- The ultrasound probe is inserted through the urethra into the bladder to assess the condition of the prostate.
4. Transrectal Ultrasound-Guided Prostate Biopsy
Under the guidance of ultrasound, a doctor uses a high-speed biopsy gun to puncture the suspected tumor location in the prostate through the rectal wall. They take 10 to 14 tissue samples from the prostate for pathological examination to confirm whether cancer is present. Local anesthesia or a painkiller may be given before the biopsy, and the procedure usually does not take too long. However, since the biopsy is an invasive procedure, patients may experience blood in urine, rectal bleeding, or even serious complications such as sepsis leading to shock a few days after the examination.
5. Imaging Examinations
If prostate cancer is diagnosed, imaging examinations may be conducted to evaluate the extent of cancer spread. These include:
X-rays can detect if cancer cells have damaged the bones or lungs.
Isotope Bone Scan
A small amount of radioactive isotope is injected into a vein in the arm, and then a scan is performed in affected areas. Abnormal parts of the bones, which absorb more radioactive material than normal bones, will be visible on the scan.
CT scan is a special X-ray examination method that takes multiple X-ray images from different angles. The images are then input into a computer to create detailed images of the internal tissues. CT scan can further examine changes in the prostate’s shape and understand the spread of prostate tumors.
6. Magnetic Resonance Imaging (MRI)
MRI uses a magnetic field to create cross-sectional images of the body. Patients need to undergo the examination inside a narrow tube to evaluate the extent of prostate cancer spread. Some individuals may feel confined or experience claustrophobia while lying inside the tube, so those with claustrophobia should take note of this.
In addition to regular check-ups, men can also use the “International Prostate Symptom Score questionnaire” (IPSS) designed by the American Urological Association to assess the severity of prostate enlargement. This can help doctors determine whether it is benign prostatic hyperplasia or other prostate problems during the initial consultation.
Please answer the following questions based on your urination condition. The scoring results will indicate the severity of symptoms.
| |
|
None |
Less than a fifth of the time |
Less than half of the time |
Roughly half of the time |
More than half of the time |
Almost every time |
| 1 |
Incomplete emptying
Over the past month, have you often felt that you haven’t completely emptied your bladder? |
0 |
1 |
2 |
3 |
4 |
5 |
| 2 |
Frequency
Over the past month, have you often had to urinate again within two hours of urinating? |
0 |
1 |
2 |
3 |
4 |
5 |
| 3 |
Intermittency
Over the past month, have you often had to stop and start again when urinating? |
0 |
1 |
2 |
3 |
4 |
5 |
| 4 |
Urgency
Over the past month, have you had difficulties holding urination? |
0 |
1 |
2 |
3 |
4 |
5 |
| 5 |
Weak stream
Over the past month, have you had a weak urinary stream? |
0 |
1 |
2 |
3 |
4 |
5 |
| 6 |
Straining
Over the past month, have you had to strain to start urination? |
0 |
1 |
2 |
3 |
4 |
5 |
| |
|
None |
Once |
Twice |
Three Times |
Four Times |
Five or More Times |
| 7 |
Nocturia
Over the past month, how many times on average did you have to wake up at night to urinate? |
0 |
1 |
2 |
3 |
4 |
5 |
| Symptom Score Results |
0-7: Mild
8-19: Moderate
20 or above: Severe |
Generally, male health check-ups include some prostate-related examinations, but they may not necessarily include all the necessary tests such as digital rectal examination, blood tests, or imaging examinations. Therefore, to ensure health, individuals at high risk should undergo comprehensive examinations regularly.
Which hospital/clinic provides prostate examination plans and costs?
The following are some male health examination plans available on the market that include prostate-related examinations. The fees vary depending on the type of examination.
The following are some male health examination plans available on the market that include prostate-related examinations. The fees vary depending on the type of examination.
在醫院進行的前列腺檢查
| Private Hospital |
Best Price |
Included Prostate Examination Items* |
| St. Paul’s Hospital |
HK$2,620 |
Prostate-specific antigen (PSA) test |
| Gleneagles Hospital Hong Kong– Standard |
HK$1,670 |
Prostate-specific antigen (PSA) test |
| Gleneagles Hospital Hong Kong – Comprehensive |
HK$3,010 |
- Prostate-specific antigen (PSA) test
- Free prostate-specific antigen (fPSA) test
- Prostate ultrasound scan
|
| Matilda International Hospital |
HK$16,700 |
- Prostate-specific antigen (PSA) test
- Free prostate-specific antigen (fPSA) test
- Prostate ultrasound scan
|
| Hong Kong Baptist Hospital |
HK$3,340^ |
Prostate-specific antigen (PSA) test |
| Evangel Hospital |
HK$7,800 |
Prostate-specific antigen (PSA) test |
| Saint Teresa’s Hospital -Standard Male |
HK$2,880 |
- Prostate-specific antigen (PSA) test
- Prostate ultrasound scan
|
| Hong Kong Adventist Hospital – Tsuen Wan – Plan 1 |
HK$1,780 |
Prostate-specific antigen (PSA) test |
| Hong Kong Adventist Hospital – Tsuen Wan – Plan 2 |
HK$5,280 |
- Prostate-specific antigen (PSA) test
- Free prostate-specific antigen (fPSA) test
- Prostate ultrasound scan
|
| Hong Kong Adventist Hospital– Plan 1 |
HK$7,300 |
- Prostate-specific antigen (PSA) test
- Free prostate-specific antigen (fPSA) test
- Prostate ultrasound scan
|
| Hong Kong Adventist Hospital– Plan 2 |
HK$9,420 |
- Prostate-specific antigen (PSA) test
- Free prostate-specific antigen (fPSA) test
- Prostate ultrasound scan
|
| Union Hospital |
HK$2,990 |
- International Prostate Symptom Score (IPSS)
- Prostate-specific antigen (PSA) test
|
Prostate examinations conducted in clinics/medical centers:
| Clinic/Medical Centre |
Best Price |
Included Prostate Examination Items* |
| Kinetics HK |
HK$400 |
Prostate-specific antigen (PSA) test |
| Kinetics HK |
HK$1,750 |
Prostate ultrasound scan |
| PacifiCheck |
HK$2,080 |
- Prostate-specific antigen (PSA) test
- International Prostate Symptom Score (IPSS)
- Prostate ultrasound scan（+HK$700）
|
| PacifiCheck |
HK$4,380 |
- Prostate-specific antigen (PSA) test
- International Prostate Symptom Score (IPSS)
- Prostate ultrasound scan
|
| Bowtie & JP Health |
HK$1,840 |
Prostate-specific antigen (PSA) test |
| Medtimes Medical Group |
HK$3,180 |
- Prostate-specific antigen (PSA) test
- Prostate ultrasound scan
|
Does the government provide prostate examinations to the public?
The government does not currently provide free prostate examinations for men. However, there are several free prostate examination programs offered by medical centers, funds, and non-profit organizations in the market. Examples include the Jockey Club “Fearless Together” Program and the Chinese University of Hong Kong Jockey Club “Together Against Cancer” Program.
1. Jockey Club “Fearless Together” Program
This program, funded by the Jockey Club Charitable Trust, launched a 3-year initiative in 2020 targeting the prostate health of “professional drivers” and providing free prostate examinations to nearly 700 economically disadvantaged men. Interested individuals can register for an examination appointment on their website.
2. Chinese University of Hong Kong Jockey Club “Together Against Cancer” Program
This program offers free and basic cancer screenings, including prostate cancer screening, to eligible citizens through a “one-stop” approach. The screening methods include:
- Prostate-specific antigen (PSA) blood test
- If abnormalities are detected, further examinations such as prostate health index blood test, transrectal ultrasound scan, and biopsy may be arranged.
- Referrals are made if necessary.
In addition to the above-mentioned examinations, this program also provides participants with:
Will a prostate examination be painful?
Will a prostate examination be painful?
When a doctor suspects the presence of cancer cells in the prostate, invasive examinations may be conducted, including:
- Inserting a finger into the rectum for examination
- Percutaneous biopsy by puncturing the perineum (the area between the scrotum and anus) to extract tissue for examination
Whether these invasive examinations are painful depends on the individual’s response and the use of anesthesia. Local anesthesia can help reduce the pain experienced during the percutaneous biopsy.
After the examination, there may be some discomfort. The following conditions are considered normal:
- Blood in the urine
- Slower or weaker urine flow
Author
The Bowtie Life Insurance Company Limited is an authorized life insurance company and Hong Kong’s very first virtual insurer approved. Through the use of modern technology and medical expertise, Bowtie offers an agent-free, commission-free and more convenient online platform for customers to quote, apply and claim for Voluntary Health Insurance Scheme (VHIS) anytime anywhere. Bowtie is ranked first in the direct channel sales throughout 2021.
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