We sit down with Dr. Koushik Shaw of Austin Urology Institute to discuss the importance of prostate and testicular exams for men of all ages. Dr. Shaw has over 20 years of experience in medicine and completed his undergraduate and graduate studies at Boston University School of Medicine. He also studied under and worked with Dr. Irwin Goldstein, one of the original investigators of Viagra®. Most notably, Dr. Shaw is a member of the first da Vinci Robotic Surgery Program and is recognized as a leader in the urology field among his peers.
What can go wrong with my prostate and how often should I get an exam?
The worst and most common thing we see is prostate cancer. Screening for prostate cancer begins at age 50–55. We recommend screenings at age 50 if prostate cancer runs in your family history. Generally, you should get an annual exam with a PSA blood test once a year if you’re age 55 and up. No routine is necessary for anyone under 50 unless you have a genetic history, but this is rarely seen in men between 40–45 years old.
Is there anything I can do at home (similar to at-home breast exams) to help prevent issues in my prostate?
To maintain positive urologic health, I’d recommend regular self testicular exams. Testicular cancer can begin in teens and peaks at age 25–30. The risk of testicular cancer drops off age 40 and beyond. With at-home checks, you should become comfortable with your own anatomy. The consistency of the testicles should feel like a firm hard boiled egg. If you feel a lump, you should see your primary care doctor or your urologist. The most common sign of testicular cancer is a hard painless mass within the testicle. Another common thing found is a little irregularity in the epididymis (a small tube behind the testis, along which sperm passes to the vas deferens). This is fairly normal and doesn’t present any concern. Again, I recommend you become comfortable with your own anatomy and do a once a year check up with your primary care physician as well.
What can I expect with my first prostate exam?
It’s important to do a prostate cancer screening and PSA blood test for your first exam. The prostate exam takes around 10 to 15 seconds with a finger in the prostate. We will be looking for a firm consistency with no hard masses. Not all prostate cancer is detectable by exam—sometimes PSA blood tests find it, so it’s important to do both.
Can you tell me about the PSA blood test?
The PSA blood test is a marker secreted by the prostate in all men. A normal PSA tracker will slowly rise over time, but we look to make sure it’s a slow, consistent rise versus a large jump over the span of a year. The PSA blood test is not 100 percent reliable on it’s own, but it is a great screening tool paired with a prostate exam.
What will I learn from a prostate exam?
Hopefully your exam comes back normal in size and consistency, but if you have an enlarged prostate, we may prescribe medication, surgery, or we will simply observe over the next year. Additionally, one in every seven men is diagnosed with prostate cancer in their lifetime. If found early, it is usually curable. This is why routine screening with your primary care doctor or urologist is so important. Even if you’re a generally healthy individual, you should still get your prostate examined regularly! It’s like taking your car for an oil change—you have to provide care and maintenance for the body as well. Screen early and detect early, and you'll live a healthy life. The key to a healthy, long life is preventative care!
What are three ways exercise can help the prostate?
Most people have sedentary jobs, which usually cause more issues. My advice? Stand and move more. Walk around the office two to three times an hour. This is ultimately good for your eyesight as well; we spend so much time in front of the computer it’s great to take a break. Don’t sit for prolonged periods of time. Also, staying hydrated can help with kidney, bladder, and prostate health. Being under-hydrated causes kidney issues, kidney stones, and concentrated urine.
Masturbation and the prostate—helpful or harmful? Any other helpful facts?
Mostly we see patients suffering from chronic masturbation as a substitute for intercourse. If you’re masturabating three to four times a day, take a break—it’s all about the happy medium. Ultimately, masturbation shouldn’t be a substitute for sex. Studies show that most individuals in healthy relationships have intercourse six times a month, which is more than enough to maintain a healthy prostate. It’s not harmful to not masturbate, but it is harmful if you overdo it. Usual symptoms include prostate and penile pain.
What foods do you recommend for a healthy prostate?
I recommend a diet low in red meat and high in fruits, leafy greens, and vegetables (especially those high in lycopene, like red tomatoes). It’s not rocket science—just eat healthier! Research shows that diets lower in red meat consumption and low-carb diets reduce risk of cancer and are shown to be helpful for your overall health. At the end of the day, what’s good for your prostate is good for your body!
Any other advice you would like to share?
Treat your body like a well-oiled machine or car. Feed it well, give it good fuel and go in for a pit stop. Take a break for yourself to care for your body. Even if you feel healthy, still get checked! That’s the best way to stay out of trouble.
When Dr. Koushik is not practicing medicine, you can find him running the trail at Lady Bird Lake, exploring Austin with his wife, or volunteering with the Breakthrough Organization—a program for low-income students aiming to become first-generation college graduates.