My urologist has expressed his frustration with doctors that do not conduct a DRE. He said that no one likes doing it or receiving it but it, though uncomfortable, is quick, painless, easy and effective.
I am 74, have BPH, and my PSA runs 5-7 for the last few years. My urologist gets that checked twice a year, and does a DRE every 12 to 18 months.
Thanks for posting. Condolences. Health / life BUMP.
Unless the tumor is on the "dark side of the moon" or middle section of the prostate.
Sorry about your brother. He didn’t have symptoms until too late? What were they?
Yes Thanks for the post.
I’ve been wondering….my PSA went up, barely over 4, a year ago. My Doc at that time did not do a manual, but did recommend imaging. It showed a spot, he did a biopsy, and found very low levels of non-aggressive cancer type. Since then, my PSA has decreased to 3. But I do now feel some slight pain at times.
New Doc did a digital test. He says he’s “old school”, and it’s simple and easy enough to justify doing.
We’re monitoring PSA now…. But I’ve wondered if it’s still reliable?
VA stopped doing PSA as a routine test. “Unreliable” I was told. Have read similar reports to that effect.
I am 67. PSA has been above 4.0 since age 50. I have been on a “watch and wait” regiment ever since, with PSA tests 2X per year. Over the last 10 years, I have consistently tested above 10.00 — mostly in the 13 to 17 range. I have had four biopsies and three hi-resolution MRIs. The best they can say is that I have “suspicious area that we need to keep an eye on” and that I have a very large prostate (BPH).
Most recently, my urologist has prescribed both the IsoPSA blood test and MPS2 urine test, both of which predict the likelihood of developing clinically significant prostate cancer over the next few years. My test results show that I have a 20% risk, which is high, but not so high to warrant another biopsy at this time. Watch and wait.
Several instances in the last few years suggest strongly that MRI confirmation for Prostate Cancer is the gold standard but it seems most urologists do not recognize this and prefer to do the needle biopsy. MRI carves them and the procedure out of the picture. Hmmmm
. PSA remains only an indicator and scarcely a good means for tracking. There are at least two methods of PSA and each gives a different result compared to each other and even for the same method from lab to lab and test to test. This is hardly a recommendation for use as a progress of cancer tracking means. LIkewise of DRE, it is merely a step up from indications given by PSA and to be followed by more definitive means such as the MRI or needle biopsy. DRE is only subjective at the hand of the examiner and can’t be repeated with precision, there is no precision involved. On that matter, needle biopsy is not the gold standard either as it can simply miss the tumor if it is small.
If my time comes for this I will seek out the MRI. Meanwhile I will continue my annual PSA and respond to that as indicated.
My Dad died of prostate cancer and neglect. Maybe I will find out why someday.
Diagnostic tests are not meant to be the sole indicators of disease.
Get a colonoscopy... It’s the only way to be sure.
“My urologist has expressed his frustration with doctors that do not conduct a DRE. He said that no one likes doing it or receiving it but it, though uncomfortable, is quick, painless, easy and effective.”
17 years ago I survived a Robot-Assisted Radical Prostectomy. My PSA had gone from 3.0 to 21 in a year.
My eye twitched uncontrollably when your post’s discussion turned to DRE’s. I’ve had a few. One observation and THEN we are to NEVER discuss this again!
Male doctors are HORRIBLE at THIS!!
They lube up, stick their gloved finger in you, QUICKLY pull the finger out THEN rush to the sink to wash their finger with Comet Cleanser.
Just .. . WHAT did you LEARN from THAT, Doctor?
They KNOW that if they spend more than 1/2 a second for the ENTIRE procedure then the patient will think the doctor is a homo. They’ll say, in their BEST John Wayne voice, as they furiously scrub their fingers, “I don’t know about YOU, but I’m going after them Indians.”
I had a FEMALE doctor give me a DRE. She took her time. She searched. Something NO male doctor EVER did. She was NOT
intimidated or cowed by the examination and did her JOB, which was to collect as much evidence as she could that would help in a diagnosis.
I wish you the BEST!
I’ve been on active monitoring for 4 years now. PSA has been hovering around 4 but has now crept up to 6. My last MRI showed a bigger area of concern than before - having another biopsy in a few weeks to determine the next step. My urologist says increased PSA might be from increased BPH rather than worse cancer, so we’ll see. I’ve had 1 DRE and neither one of us enjoyed it so we haven’t had any more.