Kevin Boyd
CONSUMER HEALTH INTERACTIVEBelow:
• Do I really need this exam?
• What should I expect?
• Are there other tests for prostate cancer?
• What if the doctor finds a lump?
Do I really need this exam? If you're 50 or older, yes. Sure, it's uncomfortable, maybe even a little embarrassing. But there's good reason to have it. The doctor will manually check your prostate -- a walnut-sized gland that surrounds the duct connecting the bladder with the penis -- to look for signs of prostate cancer. The American Cancer Society recommends this procedure for all men aged 50 and up. Men at particularly high risk of prostate cancer (including African Americans and anyone with prostate cancer in his family) should start being examined at age 45. But that's not the only reason to have the exam. The doctor will also check to see if your prostate is enlarged, a common problem in men who are middle-aged or older. If you've noticed problems with urination -- an urgent need to relieve yourself, a weak stream or leaking, or unusually frequent urination, especially at night -- you may have an enlarged prostate that's blocking the urine flow from your bladder. If you think this could be the case, call your doctor and set up the exam. What should I expect? Usually painless, the digital rectal exam, or DRE, takes a minute or less (though it may seem longer). The doctor will ask you to bend over or lie on your side; then he or she will insert a gloved, lubricated finger into your anus and check the rear surface of the prostate for abnormalities. Hardness or a lump, for example, might be a sign of prostate cancer. Are there other tests for prostate cancer? There's a blood screening known as the PSA test, but the digital rectal exam sometimes picks up cancers the blood test misses. The manual exam isn't an ideal screening tool; your doctor can't feel tumors that are on the front of the prostate or buried in the middle. But because the exam is cheap and simple, there's little reason not to have it. What if the doctor finds a lump? Don't panic; it doesn't necessarily mean you're in trouble. About half of the time, a suspicious bump in the prostate turns out not to be cancer. If both your exam and your PSA test suggest that cancer may be present, your doctor will likely order a biopsy so that a sample of tissue can be examined under a microscope. -- Kevin Boyd, formerly a freelance health reporter, now works in the communications department at UCSF Medical School in San Francisco, California.
Further Resources K. Winston Caine, Peffy Garfinkel and the Editors of Men's Health Books, The Male Body: An Owner's Manual. Rodale Press, 1996.
References
National Library of Medicine. Digital rectal exam. Updated 9/10/01.
Adolfsson J, Steineck G, et al. Recent results of management of palpable clinically localized prostrate cancer. Cancer 1993;72:310-322.
Coley CM, Barry MJ, Fleming C, et al.: Early detection of prostrate cancer: part II: Annals of Internal Medicine 126(6): 468-479, 1997.
Chan EC, Sulmasy DP: What should men know about prostrate-specific antigen screening before giving informed consent? American Journal of Medicine 105(4): 226-274: 1998.
Chodak GW, Thisted RA, et al. results of conservative management of clinically localized prostrate cancer. N Engl J Med 1994;330:242-248.
Denis LJ: Prostrate cancer screening and prevention: "realities and hope". Urology 46(Suppl 3A): 56-61, 1995.
Schroder FH, Bangma CH: The European ramdomized study of screening for prostrate cancer(ERSPC). British Journal of Erology 79(Suppl 1):68-71, 1997.
American Cancer Society. Physical Exam Can Find Some Prostate Cancers with Normal PSA. June 7, 2002.
Reviewed by Bruce Biller, M.D., director of the Harvard Business School Health Services and a board-certified internist with subspecialty training in endocrinology.
First published June 1, 1999
Last updated March 3, 2008
Copyright © 1999 Consumer Health Interactive
|
