What Can a Patient Expect From a Digital Rectum Exam?

A digital rectum exam is a common procedure for prostate cancer patients.

digital rectum examTo establish a diagnosis and stage the patient it is important to perform a digital rectal exam on a patient with suspected prostate cancer. Since most of these cancers are developing on the outer cells of the gland, when your doctor performs a rectal digital rectal exam, he will feel a hard nodule which will then prompt him to do more tests such as a PSA serum test and biopsies that will lead to the diagnosis.

Over the past 15 years with the introduction of the PSA Test in the blood, many cancers are diagnosed before they can be felt on a digital rectal exam. Therefore the digital rectum exam has become less important of a diagnosis modality in the United States.

Farshid Dayyani, MD:  The prostate gland is found in men and is located between the bladder and the rectum and mainly is producing enzymes that are important in the composition of the sperm.

The prostate is a male gland that is found between the bladder and the rectum and wraps around the male urethra.  Its main function is to produce enzymes that are found in the male sperm.  With age, the size of the prostate gland increases leading to urinary symptoms in most men with advanced age.  The changes in the prostate cancer cells are different between those found in the inner core of the gland that affect the urine stream and those that are more dangerous around the outer cells of the gland that can be actually felt through the rectum and that’s why for a long time, the rectal digital exam was important in identifying men who are developing prostate cancer.  Since most of these cancers are developing on the outer cells of the gland, when your doctor performs a rectal digital exam, he will feel a hard nodule which will then prompt him to do more tests such as a PSA serum test and biopsies that will lead to the diagnosis.  Now over the past 15 years with the introduction of the so called PSA test in the blood, more and more cancers have been diagnosed before they can be felt on a rectal exam and therefore, this has become less important of a diagnosis modality in the United States, but still today in terms to establish a diagnosis and stage the patient, meaning trying to establish how far advance the tumor has gone, it is important to perform a rectal exam on every patient with suspected prostate cancer.

Farshid Dayyani
Dr. Dayyani earned his medical degree in Munich, Germany at Ludwig-Maximilians Universitaet before completing his internal medicine internship and residency at Beth Israel Deaconess Medical Center in Boston, Mass.
Farshid Dayyani

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