Penny Arcade - Comic - Going Pro

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Penny Arcade - Comic - Going Pro

Videogaming-related online strip by Mike Krahulik and Jerry Holkins. Includes news and commentary.

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Undead Scottsman

Yup, there it is. The fabled "Old enough to make prostate exam jokes" comic. It's finally here.

Let us all collapse into dust.

Djiem

I thought it was just one finger that feels around for the prostate. Unpleasant, sure, but hardly the end of the world. Am I missing something?

Hevach

Djiem wrote: »

I thought it was just one finger that feels around for the prostate. Unpleasant, sure, but hardly the end of the world. Am I missing something?

Unless they say, "Hmm... Interesting. I've got a few med students here, mind if I bring them in?"

wyld_thang

Hevach wrote: »

Djiem wrote: »

I thought it was just one finger that feels around for the prostate. Unpleasant, sure, but hardly the end of the world. Am I missing something?

Unless they say, "Hmm... Interesting. I've got a few med students here, mind if I bring them in?"

I think: This is kind of a personal moment so: Yes, I do mind! is a valdi answer to that...

Hevach

Doesn't matter if you decline, if the doctor says that you're about to get unpleasant news. The question is will you get it straight away if you decline or will you get to watch the students play 20 questions and try to guess it.

RatherDashing89

Djiem wrote: »

I thought it was just one finger that feels around for the prostate. Unpleasant, sure, but hardly the end of the world. Am I missing something?

"It's only one finger" is almost never going to comfort me. That number of fingers needs to be reduced by 100% before it's no big deal for me.

Rhesus Positive

I like that Gabe was looking for a... the term that springs to mind is "butt buddy", but that's not what I'm going for

Just two pals, getting examined together, holding hands for moral support

It's sweet

ironzerg

So, I went for "this" check up, and my doctor was kind enough to explain to me that the invasive finger test isn't necessary anymore.

If you feel like you're having an issue, they're going to run some tests and do some blood work. If there are no issues that you're concerned about, they're still going to draw some blood, and run some tests.

Either of those options are more accurate than sticking your finger in someone's asshole.

If you're going to a doctor who still insists on sticking his finger in your ass, I'd ask a few more questions.

Bremen

ironzerg wrote: »

So, I went for "this" check up, and my doctor was kind enough to explain to me that the invasive finger test isn't necessary anymore.

If you feel like you're having an issue, they're going to run some tests and do some blood work. If there are no issues that you're concerned about, they're still going to draw some blood, and run some tests.

Either of those options are more accurate than sticking your finger in someone's asshole.

If you're going to a doctor who still insists on sticking his finger in your ass, I'd ask a few more questions.

That's what happened to me and honestly I had kind of conflicting thoughts. I mean, I don't like the idea of the exam itself (it would have been my first, as I age like Gabe and Tycho), but if I have a prostate issue I'd kind of prefer to know even if it means dealing with discomfort. I'd want to be very convinced that the PSA test is not going to miss anything the exam would.

Steel Angel

Djiem wrote: »

I thought it was just one finger that feels around for the prostate. Unpleasant, sure, but hardly the end of the world. Am I missing something?

Even just one can be extremely uncomfortable if one is entirely unaccustomed to having anything entering that location. I had a series of procedures done to take care of some hemorrhoids and the first finger exam was extremely unpleasant. Subsequent ones less so but still not great, even after ones where a camera or other device needs to go up there have recalibrated things a bit.

CrimeRobot

Rhesus Positive wrote: »

I like that Gabe was looking for a... the term that springs to mind is "butt buddy", but that's not what I'm going for

Just two pals, getting examined together, holding hands for moral support

It's sweet

Not exactly the same, but similar, is the fact that Steve Martin, Martin Short, Tom Hanks and another friend of theirs have biennial "colonoscopy parties" where they all get together the night before to eat Jell-O and whatnot, before going to all get the procedure the next day.

https://www.today.com/health/martin-short-tom-hanks-steve-martin-have-colonoscopy-parties-t131499

furlion

Modern blood work is so much better and more accurate about this then the old finger. Not that it never happens, but it is pretty rare. Generally only if you complain about something that indicates to the doctor that they need to do it.

dennis

To all my aging fellows, I say, "Welcome to the Digital Age!"

No, I don't mean as in electronics.

Jokes, aside, PSA can be quite inaccurate.

In fact, studies have shown that about 70% to 80% of men with an elevated PSA who have a biopsy do not have cancer. However, many men undergo an ultrasound and prostate biopsy, to be certain.

Conversely, the PSA test doesn’t detect all cancers. About 20% of men who have cancer also have a normal PSA (less than 4 ng/ml), so the test may give some men a false sense of security.

https://www.health.harvard.edu/blog/is-psa-reliable-20110327214

"Oh no! But I didn't want to get poked!"

Well, the thing is, the poke is even less accurate:

A previous review article found that the DRE detected a mere 28.6% of prostate tumors. This means that a negative (normal) DRE does not mean you do not have PCa. In fact, the DRE misses the majority of prostate tumors. So, while a positive (abnormal) DRE may lead physicians to recommend a prostate biopsy, does a negative DRE lead us to recommend against it? The answer is no.

Now some doctors may argue, “What if I feel a nodule? Surely, that means the patient likely has prostate cancer and should get a biopsy.” Well, according to data collected from the Prostate, Lung, Colorectal, and Ovarian (PLCO) screening trial, this is also not the case. Of 5,064 men with an abnormal DRE and normal PSA, only 2% were diagnosed with PCa that would require treatment. Therefore, if a negative DRE doesn’t help us feel confident that we can avoid a biopsy, and a positive DRE doesn’t help us feel confident that we need to do a biopsy, then why should physicians perform it at all?

We shouldn’t. Since PSA screening became the norm, physicians have used PSA levels, not the DRE, as the main determining factor in decision-making for PCa screening. The data overwhelmingly supports PSA measurements as a more accurate and objective test for PCa screening. This is reflected in the fact that the American Urological Association (AUA) guidelines for PCa screening only recommend PSA screening and do not recommend the DRE as a primary screening tool. The guidelines state that the DRE, which has no proven benefit as a primary screening test, should only be considered as a secondary test.

https://www.renalandurologynews.com/home/news/urology/prostate-cancer/eliminate-digital-rectal-examination-prostate-cancer-screening/

Which isn't that surprising, given that a) they can only feel part of the prostate and b) you're relying on the diagnostic value of what a human fingertip (granted, a nerve-rich part of the body) can feel between a layer of rubber gloves plus a later of intestine.

If you just want to go that extra mile, or you have a family history of prostate cancer, you might want to get a secondary index of potential problems, inaccurate as it is. But it seems like for most people with normal PSA results, you can tell the doctor not to put a ring on it.

Rhesus Positive

dennis wrote: »

Which isn't that surprising, given that a) they can only feel part of the prostate and b) you're relying on the diagnostic value of what a human fingertip (granted, a nerve-rich part of the body) can feel between a layer of rubber gloves plus a later of intestine.

That's why I tell him to leave the glove off

Anon von Zilch

I accept only the very best, which is why I'm having mine checked at the Prostitute.

Rhesus Positive

Anon von Zilch wrote: »

I accept only the very best, which is why I'm having mine checked at the Prostitute.

That's a deep podcast cut 👍

Delzhand

That Harvard blog post seems to be saying that a single PSA can be inaccurate, that's why the recommendation is to look at PSA levels over time to see if there's a deviation

And most doctors observe how a man’s PSA level changes over time, a measure called PSA velocity, rather than using it as a one-time indicator. PSA scores tend to rise more rapidly in men with cancer than in those with BPH, for example

So PSA is still going to be way better than DRE, because DRE's over time rely on... what? The doctor's memory of how the back of your prostate felt last year?

dennis

Delzhand wrote: »

That Harvard blog post seems to be saying that a single PSA can be inaccurate, that's why the recommendation is to look at PSA levels over time to see if there's a deviation

And most doctors observe how a man’s PSA level changes over time, a measure called PSA velocity, rather than using it as a one-time indicator. PSA scores tend to rise more rapidly in men with cancer than in those with BPH, for example

So PSA is still going to be way better than DRE, because DRE's over time rely on... what? The doctor's memory of how the back of your prostate felt last year?

You know how some people never forget a face? Well...

Djiem

dennis wrote: »

Delzhand wrote: »

That Harvard blog post seems to be saying that a single PSA can be inaccurate, that's why the recommendation is to look at PSA levels over time to see if there's a deviation

And most doctors observe how a man’s PSA level changes over time, a measure called PSA velocity, rather than using it as a one-time indicator. PSA scores tend to rise more rapidly in men with cancer than in those with BPH, for example

So PSA is still going to be way better than DRE, because DRE's over time rely on... what? The doctor's memory of how the back of your prostate felt last year?

You know how some people never forget a face? Well...

Thinking back about all those dogs sniffing everyone else's buttholes... do they know something we don't?

Lttlefoot

I’m glad I’m not going to get old

Delzhand

Listen every dog large enough to sniff human butts is always going about it anyway so if they could let us know if we've got butt cancer at the same time that'd be great

dennis

Delzhand wrote: »

Listen every dog large enough to sniff human butts is always going about it anyway so if they could let us know if we've got butt cancer at the same time that'd be great

It'd definitely make the check-up a lot more pleasant.

"Who's a good boy? Who's a good boy? Do I have cancer? Do I have cancer? Awww, that sounds bad, but I just can't stay mad at those sad eyes! Who wants a belly rub!"

Overkillengine

"What's that Lassie? Little Timmy has tumors again? And they're malign?"

zepherin

Hevach wrote: »

Djiem wrote: »

I thought it was just one finger that feels around for the prostate. Unpleasant, sure, but hardly the end of the world. Am I missing something?

Unless they say, "Hmm... Interesting. I've got a few med students here, mind if I bring them in?"

My friend was having something cut out of his arm, and the med students had a bet going on what it was. Whoever had calcium deposit won that bet.

hiraeth

Got diagnosed with a prostate lesion a few years ago. I can write about what I went through and what they actually do if anyone is interested for curiosity or awareness, it's difficult when you're alone and don't know anything about what goes on.