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Prostate Examination: At what age should men have regular check-ups? How much does it cost?

Among men aged 50 and above, half of them may experience prostate enlargement issues. It is recommended to undergo a prostate examination every 1-2 years. Men with a family history of prostate cancer or other diseases may need to undergo the examination earlier. Where can you get the examination in Hong Kong? How much does it cost?
Author Bowtie Team
Date 2023-08-25
Updated on 2021-03-25
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What is the prostate?Who should undergo prostate examination?What diseases can prostate examinations effectively prevent?Methods of prostate examination and what they can detectCan you evaluate/check by yourself?Does a male physical examination include a prostate check?Which hospital/clinic provides prostate examination plans and costs?FAQ

What is the prostate?

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.

Who should undergo prostate examination?

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.

What diseases can prostate examinations effectively prevent?

Examinations can help prevent the following common prostate conditions in men:

  1. Acute and chronic prostatitis
  2. Prostate enlargement (benign prostatic hyperplasia)
  3. Prostate cancer

Methods of prostate examination and what they can detect

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-ray

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

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.

Can you evaluate/check by yourself?

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.

  NoneLess than a fifth of the timeLess than half of the timeRoughly half of the timeMore than half of the timeAlmost every time
1Incomplete emptying

Over the past month, have you often felt that you haven’t completely emptied your bladder?

012345
2Frequency

Over the past month, have you often had to urinate again within two hours of urinating?

012345
3Intermittency

Over the past month, have you often had to stop and start again when urinating?

012345
4Urgency

Over the past month, have you had difficulties holding urination?

012345
5Weak stream

Over the past month, have you had a weak urinary stream?

012345
6Straining

Over the past month, have you had to strain to start urination?

012345
  NoneOnceTwiceThree TimesFour TimesFive or More Times
7Nocturia

Over the past month, how many times on average did you have to wake up at night to urinate?

012345
Symptom Score Results0-7: Mild

8-19: Moderate

20 or above: Severe

Does a male physical examination include a prostate check?

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.

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.

在醫院進行的前列腺檢查
Private HospitalBest PriceIncluded Prostate Examination Items*
St. Paul’s HospitalHK$2,620Prostate-specific antigen (PSA) test
Gleneagles Hospital Hong Kong– StandardHK$1,670Prostate-specific antigen (PSA) test
Gleneagles Hospital Hong Kong – ComprehensiveHK$3,010
  • Prostate-specific antigen (PSA) test
  • Free prostate-specific antigen (fPSA) test
  • Prostate ultrasound scan
Matilda International HospitalHK$16,700
  • Prostate-specific antigen (PSA) test
  • Free prostate-specific antigen (fPSA) test
  • Prostate ultrasound scan
Hong Kong Baptist HospitalHK$3,340^Prostate-specific antigen (PSA) test
Evangel HospitalHK$7,800Prostate-specific antigen (PSA) test
Saint Teresa’s Hospital -Standard MaleHK$2,880
  • Prostate-specific antigen (PSA) test
  • Prostate ultrasound scan
Hong Kong Adventist Hospital – Tsuen Wan – Plan 1HK$1,780Prostate-specific antigen (PSA) test
Hong Kong Adventist Hospital – Tsuen Wan – Plan 2HK$5,280
  • Prostate-specific antigen (PSA) test
  • Free prostate-specific antigen (fPSA) test
  • Prostate ultrasound scan
Hong Kong Adventist Hospital– Plan 1HK$7,300
  • Prostate-specific antigen (PSA) test
  • Free prostate-specific antigen (fPSA) test
  • Prostate ultrasound scan
Hong Kong Adventist Hospital– Plan 2HK$9,420
  • Prostate-specific antigen (PSA) test
  • Free prostate-specific antigen (fPSA) test
  • Prostate ultrasound scan
Union HospitalHK$2,990
  • International Prostate Symptom Score (IPSS)
  • Prostate-specific antigen (PSA) test
Prostate examinations conducted in clinics/medical centers:
Clinic/Medical CentreBest PriceIncluded Prostate Examination Items*
Kinetics HKHK$400Prostate-specific antigen (PSA) test
Kinetics HKHK$1,750Prostate ultrasound scan
PacifiCheckHK$2,080
  • Prostate-specific antigen (PSA) test
  • International Prostate Symptom Score (IPSS)
  • Prostate ultrasound scan(+HK$700)
PacifiCheckHK$4,380
  • Prostate-specific antigen (PSA) test
  • International Prostate Symptom Score (IPSS)
  • Prostate ultrasound scan
Bowtie & JP HealthHK$1,840Prostate-specific antigen (PSA) test
Medtimes Medical GroupHK$3,180
  • Prostate-specific antigen (PSA) test
  • Prostate ultrasound scan
  • *Different examination packages at different prices offer different examination items. The above only mentions items related to the prostate.
  • ^Only applicable to customers with Standard and Executive packages. The fees for Standard and Executive packages range from HK$2,550 to HK$9,760.

FAQ

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
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