Every man at some point of his life will be advised to have a prostate exam.  Prostate exams consist of two different procedures – one is a blood test which is a screening tool for the early detection of prostate cancer looking for a prostate-specific antigen or PSA in the blood.  The second part of a prostate exam is what is known as a digital rectal exam (DRE) or simply rectal exam, also a screening tool for prostate cancer.  A doctor will usually recommend this as part of a routine exam or it may also be done because of trouble with urination or for other symptoms. 

Many men may dread having to have a DRE.   But knowing what to expect and understanding that the whole procedure takes only a minute or two and is usually entirely painless, can alleviate fears men harbor towards an exam that could possibly save his life.

What to expect during a prostate exam – both DRE and PSA blood test

Digital Rectal Exam:

The first thing to expect is for the doctor to inquire if you are experiencing any prostate health related symptoms such as a weak urine stream, dribbling, or straining to urinate.  They will also ask you if any first degree relatives such as your father or any brothers had prostate cancer.

The next step is the digital rectal exam.  Before the doctor performs this exam, let him know if you have hemorrhoids.  During the exam, remember to breathe slowly in and out through your mouth and don’t hold your breath.  A digital rectal exam can be embarrassing for some men but just simply detach and try to relax.

Here is a step-by-step explanation of how a DRE is done:

·         The doctor will explain that he will need to insert a finger into your rectum in order to examine the prostate gland.

·         You may be asked to stand facing the examination table while bending forward and your feet apart.  Anytime you are feeling anxious or nervous about what is going on, always ask your doctor to describe each step to help you relax.

·         After putting on a surgical glove, the doctor will cover a finger in a lubricant.

·         The finger is inserted in a downwards angle as if pointing to the belly button.  At this point you may feel some pressure but it should not be painful.  If it does hurt, tell your doctor right away.

·         Once the finger is inserted, the doctor will wait for the external sphincter muscle to relax which can take a few seconds.

·         While the doctor examines the prostate, you may be aware of some movement of the finger before it is removed.  The doctor is moving his finger in a circular motion in order to identify the lobes and groove of the prostate gland while he is checking on the size and shape of the prostate. 

·         Before the doctor removes his finger, he will tell you he is doing that.

·         After the exam is done, the doctor will offer you some tissue or pre-moistened wipes to clean off the lubricant.

·         At this point, you will be allowed some privacy to get dressed before discussing the results with your doctor.  If any areas of concern are found, additional testing may be required.  Your regular activities can be resumed immediately following a DRE with only slight bleeding from the rectum afterward.

PSA blood test:

The PSA test is a blood test which is used primarily to screen for prostate cancer.  The test measures for the amount of prostate-specific antigen (PSA) in your blood which is a protein produced by both cancerous and noncancerous tissue in the prostate.  Following the completion of the blood test it may take a few days to get the results. 

 The test itself is simply withdrawing blood from your arm with the blood sample sent to a laboratory for analysis. The results are usually reported as nanograms of PSA per milliliter (mg/mL) of blood.

Both procedures – the PSA blood test and the DRE exam – are important screening tools all men should not shun.  They are necessary tests performed at regular intervals during a man’s life helping to detect if a man has prostate cancer.  If you are a man over the age of 40 and have never been screened for prostate cancer, contact your doctor and make an appointment as soon as possible – it could save your life.