Prostate Cancer Exam

Medically Reviewed by Shruthi N, MD on September 10, 2024
Written by Alyson Powell Key
4 min read

A prostate exam is a test that checks for early signs of prostate cancer. It doesn't reveal cancer, but if the test shows an abnormal result, your doctor will likely need to take a small sample of tissue from your prostate gland (biopsy) for further testing. There are two parts to a prostate exam:

  • Digital rectal exam (DRE). For this, your doctor inserts their gloved finger into your rectum to check your prostate gland for abnormal findings.
  • Prostate-specific antigen (PSA) blood test. This test measures the level of PSA in your blood. A high level may be a sign of prostate cancer.

Not all medical institutions agree on when you should begin screening (routine testing) for prostate cancer or even if a DRE should be part of the screening.

To help detect prostate cancer in its early stages, the American Cancer Society suggests that you talk to your doctor about the benefits, risks, and limitations of prostate cancer screening before deciding to be tested.

For most people assigned male at birth (AMAB) at average risk, discussions about screening begin at age 50. However, some doctors recommend that people with a higher chance of prostate cancer, such as African-American men or those with a family history of prostate cancer, start screening earlier.

You don't need to do much to get ready for a prostate exam. But you should tell your doctor about health conditions that could make an exam uncomfortable, such as:

  • Hemorrhoids
  • Anal fissures
  • Anal tears

Since ejaculation can cause a temporary spike in your PSA levels, your doctor may ask you to hold off on having sex 48 hours before your prostate exam.

Digital rectal exam

Doctors use the digital rectal exam (DRE) as a relatively simple test to check the prostate. Because the prostate is an internal organ, your doctor cannot look at it directly. But because the prostate lies in front of the rectum, they can feel it by inserting a gloved, lubricated finger into the rectum. 

In a private exam room, you'll undress from the waist down and cover yourself with a gown or cloth. Then, the doctor will ask you to lean over an exam table or lay on your side with your knees drawn to your chest.

They'll feel your prostate for hard, lumpy, or abnormal areas. The test takes only a few minutes to complete. You may feel slight, brief discomfort during the test. It doesn't cause significant pain or any damage to the prostate.

illustration of digital rectal exam

PSA blood test

This test involves drawing a blood sample and sending it to a lab for analysis. It measures how much prostate-specific antigen you have in your blood. There's no set level to tell doctors whether you have prostate cancer. But the higher the level, the more likely you'll need further tests, such as a biopsy, MRI, or other lab tests to check for cancer. 

 

 

 

You should get your DRE results right away and PSA test results in a day or so. You can return to your normal activities right away. It's possible that you'll have light bleeding from your rectum, but this is rare. It happens more often if you have anal fissures or hemorrhoids. Contact your doctor if you notice heavy bleeding after a DRE.

Once the results of your tests come back, your doctor may discuss them with you. If they detect a suspicious lump or area during the exam, you may need more testing.

A prostate exam is a screening tool to help your doctor check for signs of prostate cancer. It involves a digital rectal exam (DRE), where a doctor checks for physical changes to your prostate, and a PSA blood test, which measures antigens in your blood that could signal prostate cancer. People assigned male at birth (AMAB) who are at average risk for prostate cancer should get a prostate exam starting at age 50. Those with a higher chance of the disease may begin screening earlier. If your DRE or PSA shows abnormal results, you may need further testing.

Should I poop before a prostate exam?

It's okay to poop before a prostate exam if you need to, but otherwise, it's not necessary to change your bathroom habits.