Getting tested for prostate cancer: Digital exam, blood test and prostate biopsy

Prostate cancer rarely produces recognisable symptoms in the early stages. So diagnosing the cancer early, when it is easier to treat, is only possible with a blood test to check levels of prostate specific antigen, and a digital rectal examination to feel for abnormalities in the size and shape of the prostate. If the results of these tests are abnormal, further checks for prostate cancer are then undertaken.

As the prostate is located near the bladder it can be felt when a finger (digit) is inserted into the rectum. Although digital rectal examination is safe and relatively painless, some men feel anxious about the test, because the idea of having someone’s finger inserted into their rectum is unfamiliar.

Jack was diagnosed with prostate cancer following a digital rectal examination in 2000 when he was 49 years old. He decided to share his experience with other men because, “I want other guys to know that it’s a simple and painless procedure. But it could save their life. I had no symptoms of prostate cancer when I was diagnosed. And would not have had the test if I hadn’t been having annual health checks with a GP.

“When I turned 45, my GP advised me that I should start having regular checks for prostate cancer. It was news to me. I didn’t have any family member that had been affected by prostate cancer, so I didn’t know I was at risk for this condition.

“Luckily, I’d been visiting the same doctor for years and having an annual check-up, so we already knew each other. Even so, I was a little bit apprehensive when he suggested I should have a digital rectal examination. I knew what was going to happen but was unsure if there would be any pain. I was a bit nervous but I knew it had to be done. I had no reason to be worried as it was completely painless.

“However, I agreed to do the prostate cancer tests. The first one was a blood test for prostate specific antigen. It wasn’t painful, just a needle in the arm to draw out some blood for testing.

“The digital rectal examination wasn’t painful either, but it was very unfamiliar and I felt a bit uncomfortable the first time. My GP talked to me explaining what he was doing. Fortunately, I had great trust in him as he had been my GP for about 20 years at the time of the examination. But I did feel a little apprehensive, not knowing what it would feel like.

“I had to take off my pants and underwear and lie on the examination table on my back. The doctor then asked me to bring my knees up to my chest. He placed a glove on his hand and then put some lubricant on it.  He then inserted his finger into my rectum and moved it around to check for any change. There was no pain involved. It took just 15-30 seconds. After the procedure I felt fine.  No strange feelings at all.”

However Jack’s test results were abnormal. A further diagnostic test, a prostate biopsy, was needed. “The biopsy was the worst out of all the procedures I had including the radical prostatectomy I eventually had to treat the prostate cancer after it was diagnosed,” Jack said. “Unfortunately, this procedure has to be done to check if you do have prostate cancer. The PSA blood test and digital rectal examination results can sometimes be abnormal, even if you don’t have prostate cancer.

“This test needed to be performed at the hospital, by a specialist who was assisted by a nurse. Once again I found myself lying on the examination table with my pants off and my knees draw up to my chest. The specialist then inserted a lubricated anaesthetic inside my rectum. This anaesthetic numbed the area. The after a couple of minutes the specialist inserted a probe with pincers on the end to take samples by using a screen to monitor where the probe was. He took 7 samples as one he didn’t get.

“Initially, I felt fine as the nurse was holding my hand. That bit of support was great as I didn’t know what to expect. I didn’t really feel anything during the first 2 samples the specialist took. But after that each one it was like a small electric shock inside my rectum. By the last sample I was sweating and glad it was all over. Physically it was a bit painful.”

Whatever the discomfort, Jack says it was well worth it. “I had no symptoms and without the test I may not be here today. So I can’t emphasise enough, how much I would recommend other men like me, those that are healthy and don’t have any symptoms that suggest they have cancer, get regular checks for prostate cancer.

To prepare for the test, have a look on the internet so you know what to expect, because sometimes not knowing can be scary. Search for information about the rectal examination procedure and a video of it if possible.  Also find out as much as possible about prostate cancer and what procedures are available.  This will give you an insight of what to expect and what options you have.

And when you’ve found out as much as you can, don’t delay getting the test done. Whatever the discomfort involved, these simple tests can be lifesaving, as they were for me.

More information

	To learn more about how other men are dealing with this disease, visit Aussie men share their prostate cancer experiences.
	Read more about Prostate cancer.
	For more information on rectal examinations, visit Digital rectal examination.