$Unique_ID{BRK01584}
$Pretitle{Special Procedures and Laboratory Tests}
$Title{Are Regular Rectal Examinations a Must?}
$Subject{rectal exam prostate}
$Volume{P-15}
$Log{
Prostate Cancer*0007601.scf}

Copyright (c) 1991   Tribune Media Services, Inc.


Are Regular Rectal Examinations a Must?


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QUESTION:  I was amazed during a recent physical examination, when the doctor
informed me that he didn't believe that a rectal examination was much good in
diagnosing cancer in the prostate gland.  He did perform the examination as
part of his routine, but left me wondering whether there was something else I
should be doing.  What is your opinion about his statement, and do you think
regular rectal examinations are a must?

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ANSWER:  Though prostate cancer is the most common cancer occurring in
American men and the third leading cause of cancer deaths, there has been no
improvement in the statistics over the last 40 years.  There were 28,500
deaths from this cancer in 1989, and an estimated 103,000 new cases.  During
this time the recommended screening test was the digital examination, the
infamous "rectal".  But there are real problems with this method of screening.
The tumor may lie above the reach of the finger, and in early cases may not be
felt at all.  Thus a "normal rectal" does not rule out the presence of a
cancer.  In addition when the examiner does feel a bump, a "positive"
examination, needle biopsy of the gland finds a cancer in only 26-34 percent
of the cases.  Another method of screening, transrectal ultrasound, is still
considered in the investigational stage.  A recent report from the U.S.
Preventive Services Task Force, stated that there was insufficient evidence
available to recommend for or against the routine digital rectal examination
as an effective screening test for prostate cancer in asymptomatic men.  And
while both the American Cancer Society, and the National Cancer Institute both
recommend an annual examination, The Canadian Task Force on the Periodic
Health Examination has advised against this routine screening.  Where does
that leave you and your physician?  Probably right where you are, having the
examination as part of an annual check up, while understanding that this is
not the best possible technique.  Yet it is currently all that is available
that makes practical sense, and you were well advised to have it performed.
ÿ
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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
