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Prostates, PSA Tests, and Digital Rectal Exams

No guy wants to see their doctor reach for the rubber glove and lubricant.

You know what's coming.

You know from previous experience you don't like it.

But you also know you don't really have any choice. Since along with PSA testing, the digital rectal exam is all part of the screening process for enlarged prostates or prostate cancer. Done in large part to catch any cancer before it silently passes through the curable stage. Since about time any symptoms give it away, it is much much harder to cure.

PSA tests are done to measure the amount of prostate specific proteins in your blood.

The Good: A PSA exam gives your doctor an idea of what's going on with your prostate. PSA testing can signal when something bad is happening that merits further investigation.

The Bad: High PSA levels can simply be nothing more than a result of age, prostate size or BPH. Yet the false positives can lead to agonizing uncertainty for many men and their families. Not to mention unnecessary biopsies.

The Bottom Line. Warts and all high PSA testing still provides a baseline of prostate activity.

Annual Digital Rectal Exams (DRE) go hand in hand with the PSA blood test to monitor your prostate. The examination involves your doctor putting her finger up your you-know-what and poking around up there as you wriggle and squirm while bent over the exam table.

The Good: It can reveal physical changes in your prostate.

The Bad: Neither doctors or their patients look forward to this examination with undiluted pleasure. So it is often deferred. Besides 'bout the time the finger-test detects something it may be too late.

The Bottom Line: Put your dislike for the procedure aside and request an annual DRE.

There is a new way to test, that unlike PSA tests, relies on a genetic marker to screen for the presence of cancer in your prostate. You may see this referred to as the PCA3 test which refers to the gene it screens your urine for. This gene is only found in the prostate and can multiply by 34 times if cancer is present.

The Good: Possibly more accurate at predicting prostate cancer.

The Bad: Still not approved by the FDA although larger clinical trials are now in progress.

The Bottom Line: The hope is this test will be better than PSA tests at identifying prostate cancer. Since PSA is directly related to the size of your prostate. While PCA3 is not.