Prostate Cancer Flashcards
Describe prostate cancer and its prevalence.
Malignancy of the prostate gland
- 2nd most common cancer in men
- Lifetime risk = 16%
- Risk of dying from prostate cancer = 2.9%*
**NOTE: Many men die WITH prostate cancer but not FROM prostate cancer
What are the risk factors for prostate cancer?
These men should be screened:
- Older age
- Black men (also includes darker skin)
- Family history of prostate cancer,
especially < age 65
- Known or likely BRCA1/BRCA2 gene mutations
How and how often should men at risk for prostate cancer be screened?
- Use PSA for screening, not DRE*
- Screen q1 - 2 years with PSA alone for those expected to live at least 10 more years if asymptomatic
- Usually stop screening at about 70 - 75 years
*NOTE: DRE (digital rectal exam) has shown no reduction in morbidity/mortality alone or in combination with PSA
What factors can affect PSA levels?
Decrease:
- Bed rest
- 5-alpha-reductase-inhibitors (can decrease PSA by 50%+, so PSA needs correction factor if patient taking)
Increase:
- Ejaculation (resolves within 24 hours)
- Cycling
- Prostate infection
- Massage
- DRE (clinically insignificant, no longer need
to wait 72 Horus after DRE to check PSA)
No change:
- Exercise
NOTE: PSA = Protein produced by prostate gland when it’s active
What is a normal PSA level and how do PSA levels relate to prostate cancer?
- Normal PSA < 4.0
- PSA = often elevated with prostate cancer
- Up to 43% of men with prostate cancer have
normal PSA levels
*** No PSA value rules out prostate cancer!!!
What assessment findings are common with prostate cancer?
- Most men = asymptomatic when diagnosed
- ***Asymmetry, induration and nodularity =
suspicious of prostate cancer,
even if PSA = normal - Prostate feels hard &/or nodular on exam
NOTE: ***New onset ED should ALWAYS be assessed for prostate cancer!!!
How should prostate cancer be managed?
Refer to urologic management!
