Johns Hopkins Health Alert
The DRE -- Don't Skip It
- The DRE exam is an essential screening tool for prostate cancer.
Because the prostate gland cannot be seen or felt externally, your doctor will regularly perform a digital rectal examination (DRE) to assess its size, shape and consistency. A DRE is among the steps necessary to diagnose benign prostatic hyperplasia, or BPH. In tandem with prostate specific antigen (PSA) testing, the DRE exam is also an essential screening tool for prostate cancer.
The American Cancer Society and American Urology Association recommend that all men over age 50 have a DRE (along with a PSA test) once a year—and earlier if they are at high risk for prostate cancer.
Despite this recommendation, a study published in the Archives of Internal Medicine found that only 47 percent of 588 men who underwent PSA testing also had a DRE performed. Skipping a DRE means that many men with prostate cancer and a normal PSA result will go undiagnosed.
Some men avoid getting a DRE because they feel uncomfortable about the procedure—but it is not painful and lasts less than a minute. During a DRE, the patient either bends forward over the examination table, lies on his side, or kneels on the table. The doctor then inserts a gloved, lubricated finger a few inches into the rectum and gently palpates the prostate gland to feel for a nodule or lump, change in size, hard tissue or any other abnormality that might indicate a tumor is present.
Posted in Prostate Disorders on July 14, 2006
Reviewed February 2012
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A recommended basic Prostate exam includes BOTH a PSA blood test and DRE (Digital Rectal Exam). The APPARENT reluctance of your family physician (general practicioner) to do a DRE is unfortunate and the reason for it should be discussed with him. If this attitude persists and negates the performance of a sound exam, I would suggest continuing to see the Urologist for the Prostate Exam. For efficiency, you may wish to schedule such an exam immediately following the receipt of the PSA result, a copy of which you should obtain, so this information is available at the time of the Urologist performed DRE.
You are approaching the age (75-80 y/o) when many physicians believe the PSA test may be discontinued, since the risk/reward ratio tends to become unbalanced with increasing decades of aging. If you are otherwise healthy, however, you should continue, at least, until 75, at which point you might wish to discuss with the Urologist whether such annual exams remain necessary and recommended. I am an informed layman but I am not a Physician. Good Luck! - John@newPCa.org
Posted by: john@newPCa.org | November 20, 2006 2:54 PM
I am 51 years old and my gp told me that I had an "abnormal" dre- prostate felt lumpy. Am awaiting psa results and have been referred to a urologist. Question- how accurate is the dre in uncovering cancerous growths? Are there other non-cancerous conditions that might feel the same- she mentioned something about blocked ducts. My question is- what is the percentage of "abnormal dres" that actually lead to a diagnosis of prostate cancer?
Posted by: ejs | January 2, 2007 6:37 PM
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I am 73 and visit my family doctor each 6 months after lab results are in for that visit. He tests PSA (once a year) but does not do the DRE check on my prostate. I asked him once and he did do it. So,I also regularly visit a Urologist for the DRE.
My question is whether my family doctor, who seems uneasy or reluctant to perform a DRE, is he skilled enough when he does do it to really know what he is feeling for a diagnosis? Each doctor is different, but should I see a Urologist regularly for the DRE?
Comments appreciated.
V.
Posted by: V | August 4, 2006 10:43 AM