The taboo of rectal examination limits prevention and delays diagnosis and treatment

Male resistance to digital rectal examination remains one of the biggest obstacles in early diagnosis of prostate cancer in Brazil. Although it is a quick, safe, and painless procedure, many men still associate touching with shame, embarrassment, or a supposed threat to their masculinity.

According to experts, this fantasy, backed by cultural taboos, ends up having a direct impact on men’s health. Delay in diagnosis can cost years of your life.

“The physical discomfort is minimal. The biggest challenge is pre-exam bias. For many people, the imagined embarrassment is greater than the real experience. It is precisely this emotional barrier that still keeps thousands of men away from the office,” explains urologist Rodrigo Arbex.

Prostate cancer

Prostate cancer It is most common among menAfter skin, according to the Ministry of Health.
In the early stages, prostate cancer may not have any symptoms. The most common signs include difficulty urinating, a delay in starting and stopping urination, blood in the urine, decreased blood flow, and the need to go to the bathroom often during the day or night.
to The causes are not completely known, But some factors such as age, family history, obesity, diet, smoking and exposure to chemicals can increase the risk.
The disease is It was confirmed after biopsyWhich is inferred when there is any change in the blood test (PSA) or digital rectal examination, which is prescribed based on the suspicion of the specialist doctor.

In the clinic, Arbex notes that most patients feel only slight pressure during the procedure, which cannot be compared to the fear that arises around it. The scan takes only 10 seconds and is performed carefully to minimize any discomfort.

Professionals who perform this examination use gloves, lubricant and make precise movements to palpate the prostate and identify changes that blood tests, such as prostate-specific antigen (PSA), don’t detect.

Despite advances in laboratory diagnosis, rectal examination remains essential because it allows the detection of nodules, indurations, and other physical changes that are not noticed by PSA. Arbex confirms that up to 20% of tumors can be identified by touch, even in the presence of normal PSA.

Another common myth is that all men should only start touch testing after the age of 50. The recommendation is that the urologist decide, on a case-by-case basis, the best method and timing of examination, taking into account age, family history, race, and risk factors.

“Black men, obese men, or men with a family history of prostate cancer should start at age 45,” explains urologist Rodrigo Braz. “These groups require special attention because they are more likely to develop aggressive tumors.”

Patients without risk factors can wait to start screening after age 50, using a PSA test, physical examination and ultrasound.

Regularity is also important: the general recommendation is to repeat the evaluation annually, as studies show a significant reduction in mortality when monitoring is continuous.

Why is it important to perform a digital rectal exam?

Detects changes that PSA may not detect. There are cases of obvious tumors that appear even with a normal PSA;
It is quick, painless and permanent less than a minute;
Allows early diagnosis and increases The chances of recovery reach more than 90% In initial cases.
Completes blood and imaging testsand provide a more complete assessment of the prostate.
Reduces mortality rate When this is done regularly within the annual examination.

Arbex emphasizes that there are few real contraindications to the exam. In cases of acute bacterial prostatitis, for example, touching is not recommended because it can aggravate the inflammation. Otherwise, the procedure is safe and should only be performed with the patient’s consent. A frank conversation with your urologist helps reduce anxiety and dispel myths — including that screening will affect masculinity.

Warning signs and symptoms

Although prostate cancer often does not cause symptoms at first, some signs are worth investigating, especially urinary changes, such as a weak urinary stream, urgency to urinate, and waking up several times at night.

Experts warn that it is important to remember that most of these symptoms have a benign origin, such as prostatic hyperplasia – a non-cancerous enlargement of the prostate. However, only medical evaluation distinguishes one case from another and avoids late diagnosis.

Responsibility for your own health

For both doctors, emotional maturity in the face of touch reveals more about one’s responsibility for one’s health than any culturally constructed image of “power.”

In the end, taboo speaks louder than discomfort. While the physical sensation lasts for seconds, the consequences of avoiding it can last a lifetime. Prostate cancer is the second most common cancer among men in Brazil and causes more than 16,000 deaths annually, according to the National Cancer Institute (INCA).

The appropriate message on this issue is that neglecting such a quick and simple test out of shyness puts one’s life in danger. “The fear of the exam cannot be greater than the fear of losing your life,” Arbex sums up. Taking care of your health is also an act of courage.

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