The Prostate Exam Has a Bad Rap — Yet a Great Record

9/1/2026

The dreaded prostate exam has long been the punchline of jokes and a reason some men put off talking about their health. But prostate cancer screening is simpler than many men may realize. This Prostate Cancer Awareness Month, DeTar Healthcare System is encouraging men to understand their risk, know when to start screening and have the conversation with their doctor.

Prostate cancer is the most common cancer among men in the United States, other than skin cancer. The American Cancer Society estimates that more than 333,000 men will be diagnosed with prostate cancer in 2026, with about 36,000 deaths attributed to the disease. Yet when prostate cancer is found before it has spread, the five-year relative survival rate is greater than 99%.

The challenge is that early prostate cancer often causes few or no symptoms, making screening and conversations with a healthcare provider especially important.

Dr. Mark A. Gonzalez, family medicine physician with DeTar Medical Group Primary Care Clinic East, says men at average risk should begin talking with their doctor about prostate cancer screening around age 50.

“Understanding your risk factors is one of the first steps to decide whether to get screened for prostate cancer and when that screening should occur,” said Dr. Gonzalez. “African American men and men who have a family history of prostate cancer should talk with their doctor about getting screened as early as age 45. Screening can save lives, especially since prostate cancer typically has few symptoms until it becomes more advanced.”

According to the American Cancer Society, men at average risk should discuss the potential benefits, risks and uncertainties of prostate cancer testing with their healthcare provider beginning at age 50 and those with higher risk and family history should begin the conversation at age 45. Men with multiple close relatives diagnosed at an early age may need to start even earlier.

A simpler approach to screening

Updated 2026 National Comprehensive Cancer Network (NCCN) guidelines identify the prostate-specific antigen (PSA) blood test as the preferred and primary screening test for prostate cancer. A digital rectal exam (DRE) is no longer required for routine screening because it adds little to PSA testing for initial cancer detection.

“The most common screening for prostate cancer is a PSA blood test, which measures the level of a prostate-specific antigen,” said Dr. Gonzalez. “Like other cancer screenings, the PSA test isn’t used to diagnose prostate cancer, but it is a first step. An abnormal PSA test can indicate the need for additional testing.”

While a DRE is not required for routine screening, it can still be useful in certain situations. The NCCN guidelines note that it may be used as an optional baseline exam, during the evaluation of an elevated PSA — especially when PSA is 2 ng/mL or higher — or whenever a suspicious DRE is found at any PSA level.

So, the prostate exam may have a bad reputation, but the dreaded “finger wave” is no longer required for routine screening. For many men, screening can begin with a simple blood test and a conversation with their healthcare provider.

Men should also talk with their doctor about changes such as difficulty urinating, blood in the urine or semen, or erectile dysfunction. These symptoms are often caused by conditions other than prostate cancer, but they should not be ignored.

If prostate cancer is diagnosed, treatment options are available

Treatment depends on several factors, including the cancer’s stage, grade, PSA level, overall health and personal preferences.

Stephen Brown, M.D., FACR, board-certified radiation oncologist with DeTar Cancer Center, brings more than 25 years of experience in radiation oncology and specializes in advanced radiation treatment techniques, including stereotactic body radiation therapy (SBRT), intensity-modulated radiation therapy (IMRT) and 3D conformal radiation therapy.

“Prostate cancer is not one-size-fits-all, and neither is its treatment,” said Dr. Brown. “When prostate cancer is diagnosed, patients should understand their options and have the opportunity to discuss which approach best fits their cancer, overall health and personal goals.”

Radiation therapy can be an important treatment option, and advances in radiation technology allow physicians to precisely target cancerous tissue while working to protect surrounding healthy tissue.

“Early detection can give us more options,” said Dr. Brown. “The goal is not simply to treat the cancer, but to develop a personalized plan that addresses the disease while considering the patient’s quality of life.”

At DeTar Cancer Center, patients have access to a coordinated team of cancer specialists, including medical oncology, radiation oncology, hematology, infusion therapy and supportive services. Dr. Brown works collaboratively with other specialists to develop individualized treatment plans.

Start the conversation

The prostate exam may have a bad reputation, but talking with your doctor about prostate health could be one of the most important things you do for your health.

If you are 50 or older, talk with your healthcare provider about whether prostate cancer screening is right for you. If you are at higher risk because of your family history or other risk factors, start that conversation earlier.

This Prostate Cancer Awareness Month, don’t wait for symptoms to start the conversation. Early detection can make a difference. To find a primary care doctor near you, visit www.mydetardoctor.com.

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