DRE examinations post diagnosis & treatment

Skeptic 6 days ago

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177 subscribers
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I was diagnosed with prostate cancer,PSA 5.5 & Gleason score 3+3 in January 2020 (upgraded to 3+4 in 2022) put on active surveillance until 2021, during which time I underwent 2 biopsies - 1TRUS biopsy in January2021 & Interval precision point biopsy in July 2021 followed by a course of radiotherapy & hormone treatment.Initially 3 monthly PSA blood tests reducing to 6 monthly by GP after 6 months with levels regularly below 1.

Apart from PSA tests no other oncology follow up for last 3 years.

I have not had a dre since before diagnosis but have just been scheduled for one by my GP.

I was told by my oncologist following radiotherapy that dre was not really of any use.Any advice please.

Millibob 6 days ago

Hello Skeptic

It's my understanding that Radiotherapy can and will alter the shape and texture of the Prostate so a DRE after Radiotherapy will not be conclusive - in fact it will put you back on the cancer pathway.

So as long as your PSA's are all below 1 I don't see the need for a DRE!

Best wishes - Brian.

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David2017 5 days ago

Hi Skeptic , why has your Dr decided to do a DRE? It sounds rather random, was he aware that you had RT already? I agree with Brian, it won’t prove anything.

Best wishes, David

Please remember that I am not medically trained and the above are my personal views.

Worriedwife 5 days ago

Hi Skeptic, it is really encouraging to hear of your consistently low PSA. If you were my husband and not having any urinary or bowel issues, then I would be urging you to ask your GP why he/she wants to do a DRE before subjecting yourself to a procedure unnecessarily. However, if you have issues with bowels or urinary system then this might seem a sensible first step.

Skeptic 5 days ago in reply to David2017

David- Not sure although it could be that GPs are paid extra for annual checks on long term conditions such as diabetes,high blood pressure,asthma etc

Skeptic 5 days ago in reply to Worriedwife

I agree that if it is not going to provide any useful diagnosis then without any other symptoms it seems unnecessary & I will question GPs reason.

Grundo 5 days ago

Hi Skeptic

I reckon Dre not much use after RT as prostate turns to a kind of mush so won't feel the same as before anyway.

The only thing u need is PSA tests cos that is what PSA was invented for, testing after treatment.

As long as no continuing upward trend all ok

Best wishes

Steve

David2017 5 days ago in reply to Skeptic

Skeptic said:
it could be that GPs are paid extra for annual checks

That would be an error of judgement in my eyes. I want my GP on my side, not looking at me as an income generator.

Best wishes, David

Please remember that I am not medically trained and the above are my personal views.

Jeff7583d1 2 days ago

Here's the June 2025 statement from the British Association of Urological Surgeons and Prostate Cancer UK:

“The digital rectal exam is a poor test for prostate cancer. The way that prostate cancer is diagnosed has improved vastly in recent years with the introduction of MRI scans and new biopsy techniques.

“A clinician using their finger to feel the prostate is a legacy of the historic pathway; it does not add clinical value but can be a major deterrent to men coming forward for checks. In a cash-strapped, time-poor NHS, it makes no sense to do a test unless it could change clinical decision making"

Add in the effect of RT on the prostate, and it seems compelling to conclude The Doctor's Handshake (DRE) is a part of history.

Jeff

Wales

September 2025: PSA 6. T2Cn0m0 (MRI result). Pi-RADs 4.

Awaiting Biopsy Result October 2025

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