Prostate cancer symptoms: What YOU can expect from a rectal examination

Survival rates are highest when the disease is diagnosed in the early stages – and survival rates improve when when men are screened and tested early.

It is not uncommon for men to avoid check ups – or to avoid discussions about their health.

There no national screening programme for prostate cancer.

There is also no single definitive test for prostate cancer and medics have to decide which test is right for each patient.

Symptoms of the disease include needing to urinate more frequently, often during the night, needing to rush to the toilet, difficulty in starting to pee, straining or taking a long time while urinating or feeling that the bladder has not emptied fully.

Men who suspect they could be suffering with symptoms of prostate cancer should visit their GP, who will refer people for the right tests.

Guidelines by health watchdog NICE state for patients with suspected prostate cancer, consider a ‘prostate‑specific antigen (PSA) test and digital rectal examination to assess for prostate

cancer in men with any lower urinary tract symptoms, such as nocturia, urinary frequency, hesitancy, urgency or retention or erectile dysfunction.’

The most common way to diagnose abnormalities with the prostate gland is through a Prostate Specific Antigen, or PSA test.

PSA is a protein produced by the prostate and released into the blood stream in very small quantities.

More PSA is released when there is a problem with the prostate, and elevated levels can signal issues like prostatitis, enlarged prostate or prostate cancer.

However the test is not routinely available on the NHS as there are issues with the accuracy of results.

The next step for other patients is a rectal examination, sometimes known as a DRE – a type of physical examination during which a doctor or nurse inserts a finger into a patients’ rectum to feel for abnormalities.

While some people find the process embarrassing, it really only takes a few minutes and isn’t usually painful.

Prostate Cancer UK said: “The doctor or nurse will ask you to lie on your side on an examination table, with your knees brought up towards your chest. They will slide a finger gently into your back passage. They’ll wear gloves and put some gel on their finger to make it more comfortable.”

The GP might also press against the prostate gland to check for any hard or lump areas which could indicate prostate cancer.

NHS Choices said: “Pressing on the prostate gland doesn’t hurt, but it may make you feel like urinating. If there’s an infection, the prostate may feel tender when it’s pressed.”

Last month, experts agreed patients with suspected prostate cancer should have an initial MRI scan to improve detection of the disease, which could reduce the number of men having unnecessary biopsies.

A report, published in British medical journal The Lancet, estimates an MRI could help 27 per cent of men avoid an unwarranted biopsy, during which a small sample of tissue is removed from the body for examination.

Adding an early MRI scan could also reduce the number of men who are diagnosed with a cancer that later proves harmless by 5 per cent, researchers found.

The report was hailed by Angela Culhane, chief executive for Prostate Cancer UK, who praised the findings as a ‘huge leap forward’ for the ‘notoriously imperfect’ diagnostic processes currently used.