How a Doctor Performs a Prostate Exam

Depending on your general health, your age (usually 50 years old and up), or if you are having difficulty in passing urine, your doctor may advise a prostate examination. If you have no urinary symptoms but are concerned about your risk for prostate cancer, you may want to have a discussion with your doctor regarding the risks and benefits of prostate cancer screening.

You may or may not be familiar with the prostate exam procedure itself, but have you ever wondered what the doctor's looking for exactly?

There are two types of tests doctors use to screen for prostate cancer:

1. A blood test where prostate cancer can be found early by testing the amount of prostate-specific antigen (PSA) in the blood. 
2. A digital rectal exam (DRE) (where the doctor puts a gloved finger, or "digit," into the rectum to feel the prostate gland)

It is usually the DRE procedure that alarms most men. To ease your nerves here is a breakdown of what a digital rectal exam entails.

Your doctor may examine you either standing or lying down.

• If standing, you will be asked to stand facing the examination bed, with feet apart, body bent forward and your arms or elbows on the bed. Feel free to ask your doctor to give you a heads up before making any sudden movements.
• Wearing surgical gloves, the doctor will coat a finger in lubricant.
• The finger will be inserted into your rectum in a downwards angle. You may feel a little pressure or slight discomfort, but it shouldn't hurt. It is important to relax and take deep breaths and let the doctor know immediately if there is pain.
• Your doctor may have to wait a few seconds for your external sphincter muscle to relax, and may ask you to bear down as if you are having a bowel movement.
• The doctor moves the finger in a circular motion in order to identify the lobes and groove of the prostate gland. The doctor checks for:
  • Lumps on or around the prostate
  • Swelling 
  • Tenderness
  • Hard spots or bumps (the gland should be smooth) 
  • Abnormalities on the prostate
  • A normal prostate is usually around 2-4 cm long and has a triangular shape, with a firm and rubbery texture
• Once finished, your doctor will probably tell you he is going to remove his finger. You may be offered some tissue or wipes to clean off the lubricant.
• The whole procedure should take about 5 minutes from start to finish, and there are no special precautions that need to be taken prior to the exam.

If any abnormalities are found during the DRE, the doctor may order more tests and possibly schedule a prostate biopsy to see if there are any signs of cancer present.

If there are no signs of prostate cancer found during screening, the results of the PSA blood test may help to determine the time between future prostate cancer screenings. PSA levels vary by age and other factors.

Ultimately, you and your doctor will decide how often you should be screened since your diet, health and lifestyle habits are all factors on the timing and frequency of your prostate cancer screenings. Be sure to consult with your doctor if you notice any changes in your health.