• Home
  • Health & Wellness
  • Disclaimer
    • Terms of Use
    • Privacy Policy
    • DMCA Notice
Podcast
  • Home
  • Health & Wellness
  • Disclaimer
    • Terms of Use
    • Privacy Policy
    • DMCA Notice
24/7 Health News
No Result
View All Result
Home Article

Prostate cancer test: is it time to ditch the digital rectal examination?

March 7, 2023
in Article
0
Prostate cancer test: is it time to ditch the digital rectal examination?

The finger-up-the-bottom examination for prostate cancer has been drawn into question. An international panel of experts recently suggested that so-called digital rectal examination for “active surveillance” should be replaced by MRI scans.

This news may be celebrated as the overcoming of an intrusive medical examination by the forward march of technology, but what exactly is a digital rectal examination (DRE) and what are the implications of replacing it?

The DRE involves a doctor examining a patient’s rectal wall by inserting a finger into the bottom. This gives doctors access to the prostate gland, helping them find signs of cancer. Before the prostate-specific antigen (PSA) test (from drawn blood) was introduced in 1986, the DRE was the only method of screening men for prostate cancer.

The DRE can also be used to detect other cancers, such as rectal cancer and anal cancer. It can be used to check for impacted stool in people with constipation, and, under certain circumstances which won’t be discussed further, foreign bodies.

It is also used in women to check for cancer, including the spread of ovarian cancer.

Done correctly, it shouldn’t be too uncomfortable. And privacy and good communication can go a long way in overcoming embarrassment.

All medical students are taught to do it and for generations have been told that when examining patients: “If you don’t put your finger in it, you may put your foot in it.”

A man having his prostate gland examined.
A man having his prostate gland examined.
National Cancer Institute/Wikimedia

The walnut-sized prostate gland sits in the pelvis, surrounding the urethra as it leaves the bladder. Rather conveniently, it lies next to the rectum and is easily felt by the examining finger.

If it is inflamed, as in cases of prostatitis, it will be tender. And in benign prostate enlargement, which happens in middle age and causes the urinary stream to slow, the prostate gland will feel enlarged.

In cases of cancer of the prostate, the surface may be irregular and the texture firm to the touch. However, it is quite common for prostate cancer to be missed in the early stages of the disease.

The gloves are off

In the UK medical school system, great emphasis is quite rightly placed on learning good clinical skills. Over-reliance on technology is seen as potentially wasteful of scarce resources, and it would seem that patients like to think of their doctors as skilled diagnosticians. But there are times when technology is more accurate at finding disease – especially in its early stages.

Magnetic resonance imaging (MRI) provides detailed pictures of bodily structures. Unlike X-rays and CT scanning, it does not rely on ionising radiation (which is linked to an increased risk of cancer) and is thought to be safe. It is good at picking up early prostate cancer and for “surveillance” (monitoring the disease).

But MRI scans are expensive and the machines are bulky, power-hungry and usually confined to hospitals. This limits their use.

There is a blood test, the previously mentioned PSA test, which is used as a marker for diseases of the prostate, but it is not specific for cancer. When used in combination with the DRE, it helps to detect cases. But PSA levels become elevated after a DRE which makes the timing of testing awkward. It means blood needs to be drawn on a separate visit.

So what is the role of DRE in diagnosing prostate cancer? I believe it still has a place. Prostate cancer spreads easily to the bones, and it is not uncommon for undiagnosed prostate cancer to manifest as back pain when it has spread to the vertebrae. If this is suspected, then positive findings on rectal examination may lead to a more timely diagnosis and fewer delays in getting the correct treatment.

Gloves on again?

DRE performs rather better for rectal cancer. If the tumour is in a site accessible to the examiner’s finger, then up to 76% can be detected.

For constipation, the finding of impacted stool in the rectum can save the expense and radiation exposure of modern investigations, which have done away with X-rays of the abdomen in favour of radiation-intensive CT scans.

Has the rectal examination had its day? I think not. It’s a cheap examination that yields useful information when used and interpreted correctly.

The Conversation

Stephen Hughes does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

ShareTweetSharePin
Previous Post

Springing forward into daylight saving time is a step back for health – a neurologist explains the medical evidence, and why this shift is worse than the fall time change

Next Post

Pancakes won’t turn you into a zombie as in HBO’s ‘The Last of Us,’ but fungi in flour have been making people sick for a long time

Next Post
Pancakes won’t turn you into a zombie as in HBO’s ‘The Last of Us,’ but fungi in flour have been making people sick for a long time

Pancakes won't turn you into a zombie as in HBO's 'The Last of Us,' but fungi in flour have been making people sick for a long time

Most Read

What causes stuttering? A speech pathology researcher explains the science and the misconceptions around this speech disorder

What causes stuttering? A speech pathology researcher explains the science and the misconceptions around this speech disorder

December 15, 2022
morning back pain

Morning Again Ache Trigger Is Not the Mattress

October 11, 2021
lower back pain relief exercises

5 decrease again ache aid workouts

October 11, 2021
3 years after legalization, we have shockingly little information about how it changed cannabis use and health harms

3 years after legalization, we have shockingly little information about how it changed cannabis use and health harms

October 15, 2021
Nasal vaccines promise to stop the COVID-19 virus before it gets to the lungs – an immunologist explains how they work

Nasal vaccines promise to stop the COVID-19 virus before it gets to the lungs – an immunologist explains how they work

December 14, 2022
bleeding in gum

When The Bleeding in gum Is Severe ?

October 11, 2021
Good Night Sleep

6 Causes of Good Evening Sleep

October 11, 2021

COVID vaccines: how one can pace up rollout in poorer international locations

October 5, 2021
Ten small changes you can make today to prevent weight gain

Ten small changes you can make today to prevent weight gain

October 12, 2021
Support and collaboration with health-care providers can help people make health decisions

Support and collaboration with health-care providers can help people make health decisions

December 16, 2021
Greece to make COVID vaccines mandatory for over-60s, but do vaccine mandates work?

Greece to make COVID vaccines mandatory for over-60s, but do vaccine mandates work?

December 1, 2021

Multiple sclerosis: the link with earlier infection just got stronger – new study

October 12, 2021
News of war can impact your mental health — here’s how to cope

Binge-eating disorder is more common than many realise, yet it’s rarely discussed – here’s what you need to know

December 2, 2022
Nurses’ attitudes toward COVID-19 vaccination for their children are highly influenced by partisanship, a new study finds

Nurses’ attitudes toward COVID-19 vaccination for their children are highly influenced by partisanship, a new study finds

December 2, 2022
Kick up your heels – ballroom dancing offers benefits to the aging brain and could help stave off dementia

Kick up your heels – ballroom dancing offers benefits to the aging brain and could help stave off dementia

January 3, 2023
How hot is too hot for the human body? Our lab found heat + humidity gets dangerous faster than many people realize

How hot is too hot for the human body? Our lab found heat + humidity gets dangerous faster than many people realize

July 6, 2022
The promise of repairing bones and tendons with human-made materials

The promise of repairing bones and tendons with human-made materials

January 4, 2022
As viral infections skyrocket, masks are still a tried-and-true way to help keep yourself and others safe

As viral infections skyrocket, masks are still a tried-and-true way to help keep yourself and others safe

December 14, 2022
How regulatory agencies, not the courts, are imposing COVID-19 vaccine mandates

How regulatory agencies, not the courts, are imposing COVID-19 vaccine mandates

October 24, 2021
Heart disease risk from saturated fats may depend on what foods they come from – new research

Heart disease risk from saturated fats may depend on what foods they come from – new research

November 29, 2021
Late night eating may cause greater weight gain – new research points to why

Late night eating may cause greater weight gain – new research points to why

October 12, 2022

10 Things I Learned During My Body Transformation

October 12, 2021

7 Health Benefits of Sweet Potatoes

October 12, 2021
Nobel prize: how chilli peppers helped researchers uncover how humans feel pain

Nobel prize: how chilli peppers helped researchers uncover how humans feel pain

October 12, 2021
How air filters can make COVID wards safer for patients and staff

How air filters can make COVID wards safer for patients and staff

December 1, 2021
GPs don’t give useful weight-loss advice – new study

GPs don’t give useful weight-loss advice – new study

December 16, 2022
Four ways to avoid gaining weight over the festive period – but also why you shouldn’t fret about it too much

Four ways to avoid gaining weight over the festive period – but also why you shouldn’t fret about it too much

December 22, 2022
Five ways to avoid pain and injury when starting a new exercise regime

Five ways to avoid pain and injury when starting a new exercise regime

December 30, 2022
Why suicide prevention support is crucial for people with fetal alcohol spectrum disorder

Why suicide prevention support is crucial for people with fetal alcohol spectrum disorder

September 28, 2022
Too hot to handle: Climate considerations for youth sport during the hottest years on record

Too hot to handle: Climate considerations for youth sport during the hottest years on record

July 19, 2022
  • Home
  • Health & Wellness
  • Disclaimer

© 2020 DAILY HEALTH NEWS

  • Home
  • Health & Wellness
  • Disclaimer
    • Terms of Use
    • Privacy Policy
    • DMCA Notice

© 2020 DAILY HEALTH NEWS