Category: Early Detection

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Sept. 6, 2016 – Digital rectal exam, the dreaded finger exam to check for prostate cancer, used to be a mainstay of check-ups for older men. With its value now in question, some doctors share the risks and benefits with their patients and let them decide. So, should they or shouldn’t they?

Ryan Terlecki, PhD
Ryan Terlecki, PhD
“The evidence suggests that in most cases, it is time to abandon the digital rectal exam (DRE),” said Ryan Terlecki, M.D., a Wake Forest Baptist urologist who recently published an article on the topic in Current Medical Research and Opinion. “Our findings will likely be welcomed by patients and doctors alike.”

Terlecki said the DRE, referred to by some urologists as a “clinical relic,” subjects a large number of men to invasive, potentially uncomfortable examinations for relatively minimal gain. In addition, it may deter some men from undergoing any test for prostate cancer. ...continue reading "Digital Rectal Exam To Detect Prostate Cancer Usually Unnecessary, Study Finds"

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Indications for Prostate Biopsy

Digital Rectal Exam (DRE)
suspicious for cancer at any PSA level		 PSA above 3 ng/mL High Risk of prostate cancer based on multiple risk factors.
TRUS (transrectal ultrasound) Guided Biopsy. In some circumstances, Doppler ultrasound- guided or MRI-guided biopsy may be preferred or required. If TRUS-guided-biopsy not done, follow up in 6 to 12 months with PSA/DRE. Consider testing FPSA, PHI, and/or PCA3 if PSA is between 3 and 10 ng/mL. Measure free PSA (FPSA), PHI (Prostate Health Index), or PCA3 in patients with PSA 3 - 10 ng/mL

...continue reading "Biopsy to Detect Prostate Cancer – when is it needed?"

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This chart shows the National Cancer Center Network Guidelines, 2014, for use of the PSA test and Digital Rectal Exam (DRE) for early detection of prostate cancer. Recommendations for men over age 70 are below the chart. prostate-cancer-early-detection-chart-png

...continue reading "Prostate Cancer Early Detection Flowchart"