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Re: Digital Examinations

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It was about 8 years after my radical that my urologist stopped the twice yearly digitals. While I didn't relish these "invasions," I don't think that my urologist did the exam unless he thought it was necessary.

Digital Examinations

I have been under the care of a leading urologist for 15 years for what he thought was BPH with PSA readings from 12 to 24 and negative biopsies. Three years ago, my PSA jumped to 36 and the resulting biopsy discovered stage 4 cancer. I underwent 45 days of radiation and two years of Lupron shots.My current PSA reading is .01.My doctor sees me every four months and every time he makes me bend over for a digital exam.I have been unable to get an explanation of why the need for this kind of an examination now, when we already know that I have cancer. I'm writing to see if there are other men who have cancer and who are undergoing routine digital exams or if I am a rarity. Thanks.

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PSA and Digital exams are the two diagnostic tools to indicate the possibility of PCa

What put my urologist onto my PCa was a small lump on the surface, enough to prompt a biopsy.

My PSA was only 3.7.

However I note that you have had radiation, I can only surmise that he is feeling for local regrowth or ensuring the area settles. Anyone else had this?

Digital Examinations

I have been under the care of a leading urologist for 15 years for what he thought was BPH with PSA readings from 12 to 24 and negative biopsies. Three years ago, my PSA jumped to 36 and the resulting biopsy discovered stage 4 cancer. I underwent 45 days of radiation and two years of Lupron shots.My current PSA reading is .01.My doctor sees me every four months and every time he makes me bend over for a digital exam.I have been unable to get an explanation of why the need for this kind of an examination now, when we already know that I have cancer. I'm writing to see if there are other men who have cancer and who are undergoing routine digital exams or if I am a rarity. Thanks.

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cnc5794 wrote:

> I have been under the care of a leading urologist for 15 years

> for what he thought was BPH with PSA readings from 12 to 24 and

> negative biopsies.

>

> Three years ago, my PSA jumped to 36 and the resulting biopsy

> discovered stage 4 cancer. I underwent 45 days of radiation

> and two years of Lupron shots.

>

> My current PSA reading is .01.

>

> My doctor sees me every four months and every time he makes me

> bend over for a digital exam.

>

> I have been unable to get an explanation of why the need for

> this kind of an examination now, when we already know that I

> have cancer.

>

> I'm writing to see if there are other men who have cancer and

> who are undergoing routine digital exams or if I am a rarity.

> Thanks.

The odds are strong that you really don't need a digital rectal

exam. Studies of men treated with surgery are pretty conclusive

that PSA will rise before anything will appear on a DRE. See:

http://tinyurl.com/ylcwczl. I haven't seen similar studies for

radiation but one radiation oncologist told me that a study

showed the same thing, that PSA will rise before any lump will

appear.

Your doctor may not have followed the literature on this and not

know about the studies, or he may think that a DRE is so simple

and cheap to do that there's just no reason not to do it.

I'm very glad to see that you PSA is staying low. " Stage 4 "

cancer, means that the cancer has escaped the prostate and may no

longer all be within the field that can be treated by radiation.

I hope it all was and you've been cured.

Your response to Lupron was excellent, indicating that your

cancer was very hormone sensitive. If the cancer does recur,

there's a good possibility that it will still be very sensitive

and you can knock it down again with a few more Lupron shots.

Best of luck.

Alan

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The urologist who operated on me 8 months ago hasn't done one, but the ED

urologist did at my first visit.

The best person to answer the question is the urologist. Ask him. Pin him down.

He may be working from consideration of some remote possibility that he is aware

of, and the rectal exam may be a simple way to cut off a branch of the decision

tree.

I have been under the care of a leading urologist for 15 years for what he

thought was BPH with PSA readings from 12 to 24 and negative biopsies.

Three years ago, my PSA jumped to 36 and the resulting biopsy discovered stage 4

cancer. I underwent 45 days of radiation and two years of Lupron shots.

My current PSA reading is .01.

My doctor sees me every four months and every time he makes me bend over for a

digital exam.

I have been unable to get an explanation of why the need for this kind of an

examination now, when we already know that I have cancer.

I'm writing to see if there are other men who have cancer and who are undergoing

routine digital exams or if I am a rarity. Thanks.

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