Week 7 Prostate specific antigen Flashcards
When should tumour markers be requested?
When the test result can improve patient outcome…
Inappropriate request will cause anxiety
What are two main prostatic diseases
benign prostatic hyperplasia (BPH)
prostatic cancer
prostate difference between BPH and prostatic cancer
- BPH is often due to men aging, smooth and enlarged prostate
- prostatic cancer is often nodular and very hard.
what does PSA do normally & as a tumour biomarker
It dissolves seminal coagulum -> aids sperm motility
It decreases in free-form PSA in malignant prostate cancer.
How does PSA help distinguish malignancy
Total PSA should increase in PSA tumours and BPH.
but:
If free percentage of PSA is lower, then malignancy is more likely.
What role does PSA play in prostate cancer diagnosis?
It can help assess the risk, but prostate biopsy is required for definitive diagnosis.
levels of PSA in monitoring prostate cancer
post total prostatectomy: PSA should be undetectable
radiotherapy/endocrine therapy: rate of fall is relevant
when should total prostatectomy be performed
only when the prostate tumour hasn’t metastasised.
cases where PSA may be increased
- benign prostate hyperplasia
- prostate cancer
- after catheterisation
- urinary tract infection
- prostatitis
if serum PSA is within reference range, is the patient totally fine?
no, it doesn’t exclude malignancy
If PSA elevated, does the patient definitely have prostate disease?
no, not necessarily
