How important is the DRE?

My long time family doctor a true GP discovered my aggressive and non-symptomatic pc back in 2009 - and my psa was a mere 2.9 - he most likely saved me (at the very least) from an initial diagnosis of stage 4 pc...or worse!

He felt and found something different from the previous yearly DRE and immediately ordered me off to see a urologist who confirmed and biopsied me two days later. As it was I was Stage 3 and have had quite a journey since then...so I must say an annual physical with a DRE can truly be a life saver - it sure was for me!

Bridge

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Age 63, dx at 60, PSA 2.9 ; biopsy t3b Gleason 7 (4 +3)
11/09 Post-prostatectomy: ext-prostatic growth 60% tumor both lobes; perinural + l sem ves w/lympho-vascular tumor; nodes:14 right; 9 left (no mets)
10/11 adjuvant IGRT 8 weeks
4/10/12 psa rise from 0.3;0.5;0.9 post-SRT –to med onco
5/30/12 neg bone scan; ct – enl. adrenal gland + 1 pelvic node "involvement"...
6/5/12 500mg daily use of pom extract 6/5/12 psa to 1.5… 7/10/12 psa to 2.0
7/17/12 diagnosed w/ “aggressive metastatic” pc informed I am now 'treatable not curable"; start 50mg Casodex (Bicalutamide) + 500mgpom extract
9/11/12 ct scan + psa drop from 2.0 to 0.2; shrinking lymph gland
9/27/12 radiation team to treat my lymph gland with the cyberknife
10/12/12 Gold fiducial makers as prep for cyberknife treatment
10/23 cyberknife planning session 11/12 cyberknife to begin 1 week
11/12 -11/16 underwent 5 days of cyberknife treatments
11/23/12 - continuing with oncology meds (as above)
12/14/12 - ctscan and radiation-oncology consult positive outlook post-cyberknife follow up in 3 months; psa now at 0.1
1/5/13 new psa result still at 0.1 – taken off 50mg Casodex (Bicalutamide) for now to monitor
3/12/13 psa + ctscan scheduled

OOPs, forgot to say I've never had a DRE by any urologist since my robotic surgery over 4 years ago.........

Interesting conversation here.

A female GP in "lil ole Grangeville, ID" performed a DRE on me once upon a time, and low and behold, what did she palpate with her small, narrow digits......Can you say "Nodules" boys and girls. And, all the time, my highest PSA was 0.37. No, that is not a typo, truly, it turned out to be Gleason 6 on Biopsies before surgery, and Gleason 7 after surgery and at no point did my PSA ever get above 0.37.

So, my input is, DRE's are critical, PSA's are darned questionable as a diagnostic tool, and....A DRE should not be left up to a Urologist to perform. That is flat out bunk if someone is telling you that nonsense. Any well trained physician should be trained in palpating the "walnut" and know the difference between normal and abnormal tissue.

Just my angle on it folks.

Cowboy

mspt98 - women have issues that require vistis to URO's too