In the era of MRI and other advanced imaging, do you still routinely perform a digital rectal exam on every prostate cancer patient?  

Having started my career in the era when the latest in advanced imaging was a first generation CT scan, I still perform DRE on every patient at consultation (unless they refuse). There are several reasons for this approach. First, the information you get from DRE is needed for staging purposes, whic...

My practice is different than @Mitchell S. Anscher has outlined. The vast majority of men that I see in consultation have had a mpMRI in addition to the TRUS. In my experience, the DRE rarely changes management and I perform DRE at initial consultation in a minority of men. I also see many men for d...

Not sure what this obsession is with DRE in this current era of high-quality imaging. People were even talking about this before the era of high-quality imaging (https://www.ncbi.nlm.nih.gov/pubmed/11586202).But the reason I wanted to comment was based on the statement "First, the information you ge...

Interesting discussion. I agree that a DRE at baseline is a useful test. The DRE is notoriously unreliable between different examiners, even when they are experienced urologists. Thus, a previous DRE performed by a urologist isn't the same as "truth" necessarily. (Interobserver consistency of digita...

In follow up, I generally do a rectal exam at least once a year checking for occult blood that may hint of late radiation effects.  Also, I picked up a low-lying rectal cancer on a prostate cancer patient during follow up 5 years later.

I continue to recommend digital rectal examination at the initial consultation with any prostate cancer patient. In the intact setting this is certainly useful for staging. In addition, I practice in an area where a large percentage of the patients have never undergone colon cancer screening so I al...