Prostate Cancer: why a simple exam could save your life

Prostate cancer is one of the most common malignancies among men, especially after the age of 50. Early diagnosis is crucial for improving treatment options and survival rates. The digital rectal examination (DRE) plays a key role among the available diagnostic tools, despite the growing use of PSA (prostate-specific antigen) testing and advanced imaging techniques.

What is Digital Rectal Examination?

The digital rectal examination is a simple and minimally invasive procedure in which a doctor, usually a urologist, inserts a gloved and lubricated finger into the rectum to palpate the prostate. This exam allows the assessment of:

• Prostate size and volume
• Presence of nodules or hardened areas
• Consistency and symmetry of the gland

Why is it Important?

Despite advancements in diagnostic techniques, DRE remains an indispensable method for several reasons:

Detection of Early-Stage Tumors

• In its early stages, prostate cancer may not significantly alter PSA levels, making DRE an essential complementary tool to identify suspicious nodules.

Evaluation of Aggressive Tumors

• More advanced malignancies tend to change the consistency of the prostate. An abnormal rectal exam may indicate the need for further diagnostic investigations, even if PSA levels are not particularly high.

Simplicity and Low Cost

• DRE is a quick exam, does not require sophisticated equipment, and can be performed directly in a clinic without special preparation.

Complement to PSA Testing

• PSA levels can be elevated due to benign conditions such as benign prostatic hyperplasia (BPH) or prostatitis. Combining DRE with PSA testing helps distinguish between benign conditions and suspected malignancies.

DRE and International Guidelines

Leading scientific societies, such as the European Association of Urology (EAU) and the American Urological Association (AUA), recommend DRE as an integral part of prostate cancer screening, particularly for men at high risk (family history, advanced age, African-American ethnicity).

Conclusion

Although often overlooked or avoided by patients due to discomfort, digital rectal examination is a fundamental diagnostic tool in the fight against prostate cancer. Performing it alongside PSA testing allows for a more accurate evaluation, contributing to early diagnosis and improved treatment options.

Do not underestimate the importance of prevention: be a testimonial for health! A regular urological check-up can save lives.