The Digital Rectal Exam (DRE)

The digital rectal exam, or DRE, is a quick physical examination of the prostate gland, and is used to screen for possible cancer. The American Cancer Society (ACS) recommends that men over the age of fifty should have the test on a regular basis. The ACS also recommends that men of African American heritage, or men with a family history of prostate cancer, should start being screened at age 45.

The man leans forward, resting his elbows on a table for support. Sometimes he may lie on his side, and draw his knees up to his chest. The doctor inserts a lubricated, gloved finger through the anus, and into the rectum.

 

By palpitating the rectum lining with the finger, the doctor can feel the back portion of the prostate gland. The size and shape of the gland can be estimated. The prostate gland should feel rubbery to the touch. If lumps or areas of hard matter are discovered, this may indicate the presence of cancer. The doctor can also tell if any hard areas have spread to the rectum.

A digital rectal exam does not diagnose prostate problems: it simply indicates the possibility. Often the test is performed in tandem with a PSA blood test (DREs have detected cancer missed by PSA tests).

 

If the results of a DRE are unusual, further testing may be required to confirm the diagnosis. These tests may involve a trans rectal ultrasound (TRUS), or a biopsy to examine tissue samples under a microscope.

Proponents of the diagnostic value of the digital rectal exam believe regular DRE screening can catch cancer at an early stage, improving treatment prognosis. The test is performed quickly, and has no lasting side effects (if a DRE hurts, or you experience pain after the exam, tell your doctor immediately).

 

The main disadvantage to the test, of course, is that it makes many men nervous and embarrassed. Opponents of DRE testing also argue that early detection often leads to unnecessary treatments, which can have unwanted side effects.