Prostate Examinations

I think I have got problems with me prostrate. I am getting up about eight times a night for a pee and all I get is a tiny trickle.

Actually it's your pros-tate but you are not far off the mark. The older we get the more problems an enlarged prostate can cause. Most men will die with a prostate problem rather than of a prostate problem.

That said, about 25,000 men are diagnosed with prostate cancer in the UK every year.

I know what you are going to say. 'Rectal examination'. Not even my partner gets that close.

For the average British male the idea of having even the gloved finger of a stranger up the fundament is so abhorrent, many would rather take their chances with cancer than suffer a moment's indignity. But the quickest way to test for enlargement is route one.

A mate went to his quack and he just demanded a blood test.

Doctors are also rectally reluctant simply because of the complexity and uncertainty around testing. Joan Austoker of the department of primary care, Oxford University, says that, on its own, digital rectal examination (DRE) has a 'limited sensitivity' in detecting organ confined and potentially curable disease (30 to 40% of cancers detected). Studies have questioned the value of DRE as a routine screening measure.

Effective testing requires a range of measures. Neither DRE, PSA (a blood test) or TRUP (ultrasound) alone is recommended.

So you are saying grin and bear the DRE?

Afraid so. To paraphrase Corporal Jones in 'Dads' Army', men 'don't like it up 'em'. Your doctor will try to use the least embarrassing position. Lying on your side with your knees tucked up to your chin saves face-to-face awkwardness. Just do it. It could save your life.

Mark Gould