The digital rectal exam is when the doctor inserts his/her digit (finger) into the rectum and feels for something, in this case the prostate.

Here are a list of problems I have with this exam.

  • It’s doctor dependent, some are better than others, normally a more experienced doctor can detect smaller or more subtle issues
  • The doctor can only feel the part of the prostate that is touching the rectum, that leaves 80% unchecked.
  • Normally by the time there are bumps or abnormal part of the prostate is palpable (i.e. you can feel it), the cancer is reasonable advanced, at least a T2, maybe a T4, again depending on how good your doctor is.
  • The majority of prostate cancers a first noticed at the base of the prostate. The base is the part of the prostate that abuts the bladder, the part you can’t feel.
  • It’s physically and emotionally uncomfortable. Some cultures associate the Digital rectal exam with rape, it remove their manhood.

As you can tell I’m not the biggest fan of this test. There are newer test being developed that are much better, the best being a MRI with an endorectal coil that allows the prostate to be examined with imaging.

 

The following cartoon, who I don’t know who to credit, is perfect, it says it all…

Digital Rectal Exam (DRE).

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