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PSA only for screening?

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Posted 8/5/2018 11:48 AM (GMT -5)
How important are the DRE's for screening?


My husband (late 50's) only gets the PSA done...I've been talking to him about the DRE, but so far he hasn't had one done.
Posted 8/5/2018 11:59 AM (GMT -5)
I think they are both important for screening. I don’t know that one is more important than the other. But if I had to choose, I’d want the PSA
Posted 8/5/2018 12:01 PM (GMT -5)

Pratoman said...
I think they are both important for screening. I don’t know that one is more important than the other. But if I had to choose, I’d want the PSA

I'm trying to convince him that he needs both for early detection.
Posted 8/5/2018 12:04 PM (GMT -5)
It would be best. Sometimes (not that common) more aggressive prostate cancer doesn’t put out a lot if PSA. They are both prone to false positives Nd flow negatives which is why he needs to hve both
Posted 8/5/2018 12:04 PM (GMT -5)
Girlie, the DRE is important and should definitely be a part of your husband's annual physical. While neither PSA or DRE are absolute indicators of prostate cancer, the DRE can detect abnormalities in the prostate (bumps, bulges, etc) that may be indicative of a problem. Both tests are appropriate for a man of your husband's age and the fact that his doc is not performing one of them is concerning.

Jim
Posted 8/5/2018 12:07 PM (GMT -5)

Tudpock18 said...
Girlie, the DRE is important and should definitely be a part of your husband's annual physical. While neither PSA or DRE are absolute indicators of prostate cancer, the DRE can detect abnormalities in the prostate (bumps, bulges, etc) that may be indicative of a problem. Both tests are appropriate for a man of your husband's age and the fact that his doc is not performing one of them is concerning.

Jim

Well, it's him that isn't wanting them...I'm sure his Doc will perform them.

Maybe the fact that he has a female doc has something to do with it? IDK but I keep telling him if I do the Pap tests...he can do the DRE.

I'll have another talk with him....
Posted 8/5/2018 12:19 PM (GMT -5)
Most often the DRE is uninformative (almost all are T1c - nothing felt). Most doctors don't do them properly. On the off chance that his cancer is detectable by palpation, he should have it done. It can also reveal BPH and prostatitis.
Posted 8/5/2018 12:26 PM (GMT -5)

Tall Allen said...
Most often the DRE is uninformative (almost all are T1c - nothing felt). Most doctors don't do them properly. On the off chance that his cancer is detectable by palpation, he should have it done. It can also reveal BPH and prostatitis.

I’ll have to look up BPH and prostatitis



Thanks guys - I’m not sure if this is ‘enough’ to pursuade him to have the DRE done - he does his best to avoid going to the Dr.
Posted 8/5/2018 2:53 PM (GMT -5)
He should have a DRE. I think it's an indicator of a good primary care doctor that they perform DREs. Docs don't like giving them and patients don't like getting them, so it's an easy truce not to have them. But it's bad medicine not to. I had a female physician's assistant perform a DRE on me a few years back. It was a little odd. She had another person stay in the room as a protection against sexual assault or something. The odd thing is that she found no nodule, but one was there. I had a PSA test at the same time, it it found an elevated level, which led to a visit to a urologist. He performed a DRE and found a prominent nodule, which in turn led to a biopsy, and then everything else. Later I told my primary care doctor that the assistant needed to have her finger retrained, since she had missed an obvious problem.
Posted 8/5/2018 4:47 PM (GMT -5)

Tall Allen said...
Most often the DRE is uninformative (almost all are T1c - nothing felt). Most doctors don't do them properly. On the off chance that his cancer is detectable by palpation, he should have it done. It can also reveal BPH and prostatitis.

When I was running marathons I once severe testicular pain and decided to see a Urologist. I was in my mid 30's and my PCP was doing DRE's annually. I dont think PSA test was available then. During the Urology visit he asked me if I had gotten a DRE lately and I answered that I had at my annual checkup a few months earlier. He said most doctors dont know how to do it properly. He performed one and after that I began to see him and my PCP each year.
Posted 8/5/2018 4:57 PM (GMT -5)
"Thanks guys - I’m not sure if this is ‘enough’ to pursuade him to have the DRE done - he does his best to avoid going to the Dr."

that was my MO for many years until my dentist refused to sedate me until I had my HBP treated. that's when I found out I had an elevated PSA, HBP and hepatitis C.

“I might have made a tactical error in not going to a physician for twenty years.” -- Warren Zevon
Posted 8/5/2018 5:14 PM (GMT -5)
Like everyone else is saying - he should have the DRE done.
Posted 8/5/2018 5:51 PM (GMT -5)
I would continue to encourage you husband to have the DRE. More information is better, assuming they do it right.

It was not an unpleasant experience when my female PCP did my DRE. When my Uro did the DRE it felt like he was using an auger. To my PCP’s credit, she did detect the abnormality in my prostate.
Posted 8/5/2018 5:57 PM (GMT -5)
One way the the DRE is useful is in helping understand an elevated PSA. If your PSA is high, it could be for any number of reasons and it's not clear if a biopsy is needed. If PSA is high and the doc finds something with the DRE, it is obvious you need a biopsy. That's what happened with me.
Posted 8/5/2018 6:05 PM (GMT -5)
I still remember my first DRE by my female doc back in the 1980s. I felt a bit uncomfortable. Maybe she was trying to make me feel at ease so she asked me how my wife was doing. The thought of talking about my wife while another woman has her finger in my butt, which did not feel good at all, struck me as one of the more odd experiences in my life.
Posted 8/6/2018 10:03 AM (GMT -5)
DJBearGuy - Talk about odd, my first DRE was for a job physical.

I was 21 years old.

I had no clue what he was doing, it was an 80+ year old doc.

I left thinking, that was different.
Posted 8/6/2018 10:26 AM (GMT -5)
Since I had the TRUS biopsy two years ago, I don't really object that much anymore to getting DREs because I know there's something worse than the Doctor's finger that can be poked up my backside.
Posted 8/6/2018 11:57 AM (GMT -5)

Kent M. said...
Since I had the TRUS biopsy two years ago, I don't really object that much anymore to getting DREs because I know there's something worse than the Doctor's finger that can be poked up my backside.

Maybe I should read this to hubby.
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