My PSA was under 1.0. During my annual physical, my doctor did a DRE and felt a nodule. He sent me to a Urologist who felt the nodule but said I couldn't possibly have prostate cancer with that low PSA. He said to come back in 6 months and get another PSA. I said
"What if the next PSA is also low?" and he responded that he would then do a biopsy. I told him the next PSA was pretty much irrelevant since he was going to do a biopsy regardless of the result. He did the biopsy without waiting. I had a Gleason 4+4 cancer. I had an RP, a recurrence 14 years later, Orgovyx and 37 rounds of radiation. My PSA has been undetectable in 2+ years since the hormones and radiation. This is a long way of saying that for me and about 10 % of prostate cancer patients, the DRE can be a life saver. A lot of doctors no longer do it and some journal articles recommend against it, which makes me very upset. It's quick, easy, no cost and can save a significant number of lives by discovering low PSA producing cancers in men like me.