Prostate cancer

Question 1

risk factors

Answer 1

increasing age
obesity
Afro-Caribbean ethnicity
family history
strong family history

Question 2

features

Answer 2

bladder outlet obstruction: hesitancy, urinary retention

haematuria, haematospermia

pain: back, perineal or testicular

digital rectal examination: asymmetrical, hard,

nodular enlargement with loss of median sulcus

Question 3

Ix

Answer 3

MRI prostate

Question 4

What scale is used to indicate a MRI vs Biopsy?

Answer 4

Liekert scale

Likert scale is >=3 a multiparametric MRI-influenced prostate biopsy is offered

Likert scale 1-2 biopsy discussion

Question 5

Upper limits of PSA for 50-59 years

Answer 5

3

Question 6

Upper limits of PSA for 60-69 years

Answer 6

4

Question 7

Upper limits of PSA for > 70 years

Answer 7

5

Question 8

Referral

Answer 8

men aged 50-69 years should be referred if the PSA is >= 3.0 ng/ml OR there is an abnormal DRE

Question 9

what raises PSA levels

Answer 9

benign prostatic hyperplasia (BPH)
prostatitis and urinary tract infection (NICE recommend to postpone the PSA test for at least 1 month after treatment)
ejaculation (ideally not in the previous 48 hours)
vigorous exercise (ideally not in the previous 48 hours)
urinary retention
instrumentation of the urinary tract