Here is a link to a study by the National Institutes of Health. Effect of DRE on PSA
They say it has a significant effect. Post DRE PSA is 1.5X pre DRE. Post DRE Free PSA is 2X pre DRE.
Kick your "specialist who says if makes no difference" in the nuts and see if it THAT has an effect on him delaying the DRE until AFTER the PSA blood is drawn.
Geez. It is it common sense.
Here are the NIH conclusions: "In this study, DRE significantly increased total, calculated complexed, and free PSA and percent free PSA. The increase of PSA immediately after DRE was mainly due to the increase of free PSA. The change of percent free PSA after DRE depended on the initial percentage of free PSA. Complexed PSA seems less sensitive to DRE, and its changes after DRE were clinically modest. Free PSA measurement should be done before DRE and percent free PSA should be used only when the venipuncture is done before the DRE."
Is he so anxious to stick his hand up your butt that he can't wait 10 minutes so the blood can be drawn correctly?
Print out the paper and give him copies so he can learn something. If you have to argue about
it, go to someone else. He's not worth it.
Age: 58, Mar 35 yrs, 56 dx, PSA: 4/09 17.8 6/09 23.2
Biopsy: 6/09 7 of 12 Pos, 20-70%, Gleason 4+3 Bone, CT Neg
DaVinci RP: 7/09, U of Roch Med Ctr
Path Rpt: Glsn 3+4, pT3aNOMx, 56g, Tumor 2.5x1.8 cm both lobes and apex
EPE present, PNI extensive, Sem Ves, Vas def clear, Lymph 0/13
Incont: 200ml/day ED: Trimix
Post Surg PSA: 10/09 .04, 4/10 .04, 7/10 <0.01, 12/10 <0.01
AdVance Sling 1/10/11 Dry