Digital rectal exam after radiation to the walnut....

[45RPM]

Was wondering about digital rectal exam after i get my prostate radiated with SBRT. What happens to the feel of the prostate, does radiation change drastically the feel for DRE? Are DRE still useful to detect new nodules, are they still done regularly? What happens to the nodule that i currently have, will that go away so Dr can do a DRE post radiation and not feel the bump any more?

[Tall_Allen]

He might feel some scar tissue where tumors were ablated.

[45RPM]

Do you still get annual check looking for new cancers after its radiated ?

[RonnyBaby]

In many cases, the prostate might shrink after treatment because it may have been somewhat enlarged.

Also the smoothness / overall shape of it can be telling.

I had primary RT and ADT, 3 1/2 yrs ago,

My MO still checks (DRE) about every 6 months - based on my current status and prognosis.

I'd be concerned if he didn't check - at least once year ....

[45RPM in reply to RonnyBaby]

Thank you RB!!!

[timotur]

DRE may be omitted... marginal efficacy after radiation....

Abstract

Purpose: Digital rectal examination is widely performed for following patients with localized prostate cancer after definitive therapy. This examination has marginal efficacy for detecting initial prostate cancer and postoperative recurrence. To determine the efficacy of digital rectal examination in terms of new information provided after radiotherapy we analyzed the results of digital rectal examination in the followup of patients with prostate cancer after radiotherapy.

Materials and methods: We performed a nonrandomized study in 235 consecutive patients with prostate cancer followed at a large tertiary care military hospital between January 1, 1995 and December 31, 1999. All patients had been treated with prostate radiotherapy and had no evidence of metastatic disease at the first visit within that interval. Digital rectal examination was done at followup and the main outcome measure was new information provided by that examination.

Results: A total of 1,544 digital rectal examinations were performed in 1,627 visits. New information was provided by digital rectal examination in only 30% of 286 abnormal examinations, of which more than three-quarters were related to bleeding and would otherwise have been noted on routine examination by the primary care provider. All 8 persistent recurrent prostate nodules were noted in the context of increasing prostate specific antigen.

Conclusions: Routine digital rectal examination in patients with prostate cancer after radiotherapy may be omitted from followup protocols.

pubmed.ncbi.nlm.nih.gov/115...