DRE not done anymore?

I am just past 65yo and at my annual physical my family doc said that the medical community doesnt really do a DRE or a PSA test much anymore. He said that the cure for prostate cancer was worse than the disease. It seems that that cancer was very slow growing and that its treatment is worse on a man.------any other thoughts?

I just had a long overdue physical at age 53. My office visit was pretty standard with a lengthy interview and collection of vitals - followed by standard blood work. No DRE.

I was also scheduled for a colonoscopy. Prior to the procedure, the nurse informed me that the doctor would be performing a prostate exam while I was sedated. I felt a bit of disappointment about missing the experience.

I know the official standards as to when doctors should start doing a DRE/PSA test have changed. I believe instead of routinely starting those at 40, now they pushed that to 50 (or even later). Fortunately, my doctor still does them without any hesitation at all. I suppose it really just depends on the doctor you see. For now, the insurance companies still pay for the PSA blood test -- the DRE is free anyway since it's just lumped into the cost of the physical "wellness" exam. Once the insurance companies decide that they'll no longer pay for PSA tests, then they'll disappear.

Bootboy1998, I would find another Dr. My Granddad died of the results of prostate cancer at 65 years of age. Both doctors I go to do them with no hesitation and they are both young doctors.

Get another doctor. Sounds like a line of bull to me.

Get the facts on prostate cancer, discuss with the Dr. performing your physical exam the benefits of the DRE and PSA. Likely you will need to be tested if you have urinary problems, like stream problems or leaking. If you have any doubts, seek a urologist. Personally, I prefer to know if I have the disease and will spend the dollars to find out.

I agree with others- better to know than not know. Get a DRE and PSA. Between urinary symptoms, a DRE that indicates enlarged prostate and bad PSA test you may in fact have the early stages of cancer. At that point you can choose a course of action- do nothing or do something.

What you don't know can hurt you.

Most agencies like the US Preventive Health Services Task Force recommend annual DRE for prostate cancer beginning at 50, or 40 for males at high risk (such as African Americans). The blood test, PSA (prostate specific antigen) are more controversial because of false negatives and positives, and may be done for individuals who have over 10 years to live and who can work with the physician if results are out of range. This, by the way, is no different from any screening test which can be frightening and result in a lot of additional testing after a false positive. Annual DRE's have not gone by the wayside!

A DRE for checking the prostate only misses the point of a rectal exam. It is to check both the prostate and the rectum for cancers. There are rectal cancers that have nothing to do with the prostate and are low enough to be found with a digital rectal exam. If some doctors are skipping the DRE, it is because they are lazy, don't like doing them, or don't want to scare off their male patients. But females get a rectal exam as part of their gyn check-ups and they don't have prostates. For an exam that take so little time, there is no reason not to do a DRE every time a patient comes in for a physical exam.

I am just past 65yo and at my annual physical my family doc said that the medical community doesnt really do a DRE or a PSA test much anymore. He said that the cure for prostate cancer was worse than the disease. It seems that that cancer was very slow growing and that its treatment is worse on a man.------any other thoughts?

There is an age of diminishing benefit to finding prostate cancer. You're 65. If a new prostate cancer was found, it may be (I don't know the real numbers) that it's expected mortality is 30 years. The question is, do you expect - medically - to live to be 95? Would the treatment effectively lower your life expectancy? Which situation is a better solution?

As others have said, the DRE is not only about the prostate. Discuss this with your doctor.

No DRE? What the hell have I been doing all these years? No one told me! Seriously prostatic ca is no joke. Diagnose it first and then weigh the options of what to do. I can't imagine saying that to a patient. You only have to see one poor guy with intractable bone pain from mets to the bone to know what you should do.

This sounds like personal feeling of cancer treatment versus edidence based medicine. There has been some questions posed in journals about how well minute changes can be appreciated by palpation, but no PSA??? I'd go back and demand it, or perhaps find somebody who cares about screening your health as much as you do.

I had prostate cancer at age 59. It was found by a rise in my PSA as compared to the prior year. I requested that it be removed......it was. I get a DRE every year along with a PSA test.....clear for 16 years. I think my outcome is good. The only down side is that erections require help from drugs.

Jds4med raises a good point when he speaks of diminishing returns. The vast majority of prostate cancer is very slow growing. Therefore many more will doe with it than from it. However there are some fast growing prostate cancers; early detection of them is critical.

The minimal time of a DRE makes it a no brainer in my opinion. And if I'm having other blood work done, why not include the PSA. Mine has always been ridiculously low. If it were to jump, I'd want to know what's up.

PSA is grossly overrated and the cause for countless unnecessary biopsies and surgeries.

There are so many causes for a single increased PSA, most of them completely or mostly benign. Ass play, ejaculation, low grade infection and much more can cause an increase. Loads of doctors just jump to biopsy. Biopsy can easily lead to unnecessary surgery or radiation. If a screening biopsy finds cancer on one core, you won't know if it's a pure (un)luck hit on a tiny cancer that's got decades to go or part of a bigger tumor. Usually, the docs - based on age and fear of malpractice - will recommend treatment.

I'm glad I'm not a urologist. I never wanted to be in a position where the buck stops. That's what consultants are for.

My dr still does it to me

As others have said--find another doctor!!! My GP had done DRE's on me for many years and at age 58 felt a lump and suggested that I see a Urologist. The Urologist told me that I could have a biopsy or wait and have test a year later. I had the biopsy and they found cancer in several cores. After looking at the options, I choose robotic surgery for removal. All my PSA test were lower then 4.0. so it was the DRE that found my cancer. I am now 66 yrs. old with little side effects and still get a PSA and a DRE each year. There are many sites on the Internet that provide important info on prostate cancer.

A DRE should not be a quick test, meaning that the Doctor should press around all areas of the prostate and not just a quick in and out!!!

That's right - here in Europe these kind of Tests are now only done by request of the patient!

It's also true, that after the age of 70 to 75 one can "ignore" the Prostate cancer, since it's one of these kind of cancer, which only grow very, very slow.

So the patient has a good chance to die from something quite different. And the "damage" caused by an operation often depasses the advantege by not operating.

But of couse, every patient has to decide by himself to do it or better leave it!

I think I'd get a second opinion. To be sure over reliance on PSA has led to too many unneeded biopsies and prostatectomies but to say that prostate cancer develops slowly is just not true in all cases and there is no good way to know which cancers will develope slowly and which ones develope rapidly. Now just because I am older I don't want my doctor to ignore checking for a cancer that could infact kill me. The course of action that we choose to take if something is found is a different question. Not looking is not reasonable.

My prostate has been "fried" by radiation, when getting treatments for colon cancer, years ago. My F.P. doesn't do DRE's on me anymore, but does still do PSA's.

My urologist did a DRE just as part of the total exam for seeing him for hematuria.

My GP said it's now every 2 years for routine physicals.

Went in today to see my doctor as a follow up to the colonoscopy I had a couple weeks ago. During the colonoscopy, they performed a prostate exam while i was under sedation and noted an enlarged prostate.

Today, my doctor performed a DRE and noted that - though enlarged - it seemed smooth and symmetrical. He quizzed me to see if I had any symptoms that might accompany an enlarged prostate, but I had none.

He wants to compare my PSA number in 3 months - but didn't seemed overly concerned. My current PSA was 2.12

He was concerned that I had lost 20 pounds since my initial visit and asked if I had been ill. I said, "No, fucker. You told me to eat right and exercise! WTF?" - 😃

I think I'll ask my wife to perform a DRE tonight so she can give me a second opinion 😃

Quick Edit - found this on my Health site

GU Male: The penis was normal, the scrotum was normal and the prostate was not tender. The prostate was enlarged, but did not have a nodule and was not tender . Prostate size was 2-3 on a scale of 0-4.

Rectal: Normal sphincter tone.

I just changed doctors about a year ago it is an all female practice. So far all I have had is PSA test. I do have a slightly enlarged prostate but no DRE. My last doctor which was male always did genital and DRE. So it would appear maybe they don't anymore.

I do have a slightly enlarged prostate but no DRE.

It certainly depends on the doctor and the practice. My doctor does one every year without fail. I would think if you have symptoms of an enlarged prostate that would trigger a DRE. Maybe you need to think about finding a more thorough doctor.

A problem with society, including medicine, is an increasing reliance on technology and a decreasing reliance on skill. The reliance on a lab test that's rife with inconsistencies including false positives and false negatives is an example of this movement.

An enlarged prostate not being followed via a combination of subjective symptoms, physical exam and technology is simply incomplete medical care.

My doctor still does DRE's and PSA test. He has been watching mine for a couple of years, as the PSA has raised to 4.0. The DRE shows a slightly enlarged prostate. I have been to a urologist and he also did a DRE and gave the same comments. He wanted to do a biopsy but I have deferred it. I will have another exam in July and depending on what the PSA is then I may go back to the urologist.

I get one at my annual physical and any urology appointments that I have. I don't get the idea that a doc wouldn't do this as a normal part of these visits, there is no cost and it only takes a few seconds.

My pcp doesn't do those anymore, but my uro does.

I'm not sixty yet and my doctor does one every year during my annual physical.