I had a PSA below 1. My internist did a DRE (digital exam) and found a nodule. It turned out to be an aggressive prostate cancer. I had a prostatectomy. The cancer returned 14 years later and I had 37 external beam radiation treatments. Since then, my PSA has been undetectable.

A small, but significant, percentage of men have prostate cancer which does not produce PSA. I repeatedly thank the internist who did the DRE--something many doctors do not perform and claim is unnecessary. I urge all men to get a DRE as well as a PSA. The Urologist I saw after the nodule was discovered had to be talked into doing a biopsy because he said I couldn't possibly have prostate cancer with such a low PSA.