The Digital Rectal Examination-A Scary Thought!

The IntroductionDigital_rectal_exam

My family medical history is of prostate cancer in very old age. I also met a guy named Ken Tucker. Ken’s a Rockhampton cycling coach that produced three boys of his own as national champions in the 80’s and recently coached a national under 19 women’s track champion after mentoring and coaching the Meares’ girls to national teams and Olympic medals. So when Ken Tucker looked me square in the eye and said get my prostate (and bowel) checked regularly, I listened. I made the appointment over the phone and got more and more nervous the closer the time came for the digital rectal examination! Some recent research threw some light on just how men feel about this test. It was nice to know the way I reacted was exactly how most men react as this research suggests.

The Research

345 male patients (345) who underwent a digital rectal exam for the first time from February 2006 to December 2007 were evaluated for their psychological reactions and feelings after the examination. The average age was 52.8 years and the age range 25 – 85 years.

The Results

41% of the men had felt fear (examination fear 16%, and diagnosis fear 25%), 26% shame and 48% indicated they were not thinking about anything. There was no relationship between age, educational level and emotional reactions. Most patients (97%) would undergo the exam again and 52% had considered it better than they had imagined. Of these patients, 42% were illiterate/incomplete elementary school. Only 4% described having a negative experience. The factors that persuaded the patients to book an appointment were: 50% made their own decision, 27% were recommended by a physician, 19% family/friends and 7% were influenced by the media. Wives booked 24% of the consultations. Although 85% of patients had some previous knowledge about the examination, 81% felt they had further clarification afterward. Lower educational level was related to lack of information about the test, while 52% who made their own decision had previous knowledge of the importance of the examination.

The So What?

The vast majority of the patients found the digital rectal examination less awkward than they had imagined it to be and would repeat the examination in the future. Fear and shame before the examination are present and appear to barriers to the exam. My experience supports this – as long as you find a doctor with a small hand and who doesn’t smile when putting on the rubber gloves!!

 Naccarato, A., Reis, L., Matheus, W., Ferreira, U. and Denardi, F. (2011). Barriers to prostate cancer screening: psychological aspects and descriptive variables – is there a correlation? Aging Male. 14(1): 66-71.

Photo Source: http://upload.wikimedia.org/wikipedia/commons/e/e0/Digital_rectal_exam_nci-vol-7136-300.jpg