Prostate cancer

Question 1

Clinical features of prostate cancer

Answer 1

• initially asymptomatic
• 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 2

Risk factors for prostate cancer

Answer 2

• increasing age
• obesity
• Afro-Caribbean ethnicity
  family history: around 5–10% of cases have a strong family history

Question 3

How would you investigate a patient with suspicious DRE?

Answer 3

Ultrasound guided biopsy