Prostate Cancer Screening

Having reached the age of 50, a check up with your urologist is recommended annually.

There are several methods of detecting prostate problems at an early enough stage for them to be treatable or surveyed. Let's take a look at the most common.

The Digital Rectal Exam (DRE)

Since the prostate is located by the perineum just behind the rectum, the simplest and most reliable method of detecting any abnormalities is by means of what is known as the Digital Rectal Exam (or DRE). This is by far the most effective way of detecting a tumor, adenoma or cancer.

The Digital Rectal Exam is the only means of accessing the prostate, and you should set aside all ideas of shame or embarassment. This isn't at all degrading for a man and it might easily save a life by detecting cancer at an early stage while still treatable.

What happens during the DRE ?

The doctor about to examine you will request you to get into one of the following positions:

• on your back, in the "gynaeocological" position;
• on all fours, in the "knee-to-chest" position;
• lying on your left side with legs doubled up; or
• standing upright with the upper torso leaning slightly forward.

The latter position is usually adopted for the very elderly, not so alert and having difficulty getting onto the examination table.

The doctor wearing a plasic glove lubricated with vaseline introduces his finger into the anus to feel the shape of the prostate. If practised with a degree of delicacy, the examination isn't painful except in exception cases of a shrunken anus.

The DRE is an unavoidable exam which gives an idea both of the size and the condition of the prostate.

Some men try to get out of it: "But doctor, my blood test for thes prostate is normal!" So it's necessary to explain that one can quite easily have prostate cancer with a normal PSA and that it is only the DRE which will diagnose the problem.

Then there are those who say: "But doctor, you can look at me with ultrasound on the abdomen just like with pregnant women!" So one has to reply that this is like examining the prostate at the end of a corridor, in the dark with a poor flash-light.

Why a Rectal Examination?

The Digital Rectal Exam (DRE) enables three basic parameters to be evaluated: