The effect of rectal examination on serum acid phosphatase levels in benign and malignant prostatic disease

Abstract

Serum acid phosphatase was measured in patient with enlarged benign and maJignant prostate before and after rectal examination. Amongst the patients with benign glands, rectal examination did not produce any ignificant false elevation of the enzyme. Rectal examination, however, caused a ci e in the enzyme level in a few untreated cancer patients and in cancer patients who had become refractory to hormo¬nal therapy. Thi rise would help rather than mislead in the diagnosis of malignant prostate and also in identifying treated patients who had become refrac¬tory to treatment. Thus, when serum acid phospha¬tase is properly determined, elevated levels should always arouse suspicion of malignant prostate or other lesion associated with high enzyme level even if uch determination was preceded by rectal exami¬nation. There appears to be no merit in the teaching that the determination of serum acid phosphatase should be delayed after rectal examination.