PSA

Question 1

focussed hx

Answer 1

urinary frequency, nocturia, poor flow, hesitancy, dribbling, urgency

frank haematuria, weight loss, anorexia, back pain

Question 2

explain PSA & screening components to px

Answer 2

protein made only in prostate gland –> leak into blood if present in high amount such as in cancer

blood test for PSA + DRE to examine prostate

Question 3

why is PSA not very reliable

Answer 3

cancer isn’t only reason it rises

infection (prostatitis)

enlarged prostate (BPH)

Question 4

RFs

Answer 4

FHx

black

> 45

overweight

Question 5

accuracy of PSA in numbers

Answer 5

75/100 men have raised PSA but don’t have cancer

15/100 men with normal PSA have cancer

Question 6

pros of PSA

Answer 6

reassurance if normal

can detect early signs –> early treatment

Question 7

cons of PSA

Answer 7

can miss cancer –> provide false reassurance

worry + unnecessary tests (increased risk infection, bleeding, sexual problems, incontinence) - PSA anxiety

can’t tell difference between slow-growing benign cancers vs aggressive, fast-growing cancers

Question 8

before PSA

Answer 8

no ejaculation, anal sex or heavy exercise 48hrs

No DRE in past 7 days

no biopsy in 6 wks

lemme know of any UTI symptoms

Question 9

after (what if cancer)

Answer 9

++ PSA & DRE result & RFS –> 2ww referral

hospital MRI +/- biopsy

if cancer –> MDT –> watchful waiting/active surveillance, surgery, radiotherapy