From: nobody@nowhere.net (Newby)

I have posted this over in alt.support.prostate also. So far, no
replies.

My Doc does the DRE followed by the drawing of blood. Does it make any
difference in the PSA results if the DRE is performed just prior to
drawing blood for the PSA? I have read somewhere the blood should be
drawn before the DRE is performed but cannot find the article. Please
cite references if you can.
Thanks for any info.

=====> no problem - here's an article that plus reference on where it
came from.  hope this helps.....

~ curtis

-----------------------

The total PSA test and digital rectal exam (DRE) are ordered to screen
both asymptomatic and symptomatic men for prostate cancer. Since the DRE
can cause a temporary elevation in PSA, the blood is usually collected
prior to performing the DRE. If either the PSA or the DRE are found to
be abnormal, then the doctor may choose to follow this testing with a
prostate biopsy and perhaps imaging tests, such as an ultrasound. If the
DRE is normal but the PSA is moderately elevated, the doctor may order a
free PSA test to look at the ratio of free to total PSA. This can help
to distinguish between prostate cancer and other non-cancer causes of
elevated PSA. Since the total PSA test can be elevated temporarily for a
variety of reasons, a doctor may order another PSA a few weeks after the
first to determine if the PSA is still elevated.


©2001-2006 American Association for Clinical Chemistry

knowledge is power - growing old is mandatory - growing wise is optional    
"Many more men die with prostate cancer than of it. Growing old is
invariably fatal. Prostate cancer is only sometimes so."
http://community.webtv.net/PALMER_ENT/doc

I've always understood that the DRE definitely should not be done before the
PSA blood draw.  Neither is it advisable to have sex within 48 hours before
the draw.  Somewhere I recall reading that even a lot of bike or motorcycle
riding right before the test is not good.  All of these, I've read, will
most likely give you an elevated reading.

(snip)

Yes, It can make a difference to the extent of unreliable findings. It's
a pleasure to see a reference to a medic who is familiar with such
important details. Some are not.

Anything that stresses the gland can cause increases in expression of PSA.

For details see this article on the authoritative website of the
Prostate Cancer Research Institute:
http://prostate-cancer.org/education/preclin/PCRIViewOnTesting.html

Regards,

Steve J

"We must tailor the treatment to the nature of the disease. We must
listen to the biology."
-- Stephen B. Strum, MD

I rarely cite references, especially when told to, but it is a fact that
DREs and even bowel movements can cause PSAs to rise.

IIRC, I had a PSA reading of 10.3 two hours after a DRE.  A
PSA reading a month later was 8.7.

That's not proof of anything, but it's a data point to consider.

I am surprised at the number of doctors, including urologists,
who don't believe this and think that it doesn't matter if a DRE
is done immediately before a blood draw.  Even if the evidence
for it were inconclusive, it would make sense to me to not
take chances.

    Alan

This is pretty basic, if your doctor does the DRE before the PSA, i
would get a new doctor, he is not very well informed.

found this web site for you, hope it helps. Kim

http://www.prostate-cancer.org/education/preclin/PCRIViewOnTesting.html