Prostate Cancer

The cause of prostate cancer is not fully understood, but the most important risk factors are increasing age, family history of the disease, and ethnicity. Hormonal influences, particularly androgens, support the growth of prostate tissue, and lifestyle and dietary factors are thought to contribute to overall risk.

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Early prostate cancer is often asymptomatic. As the tumor grows it may cause lower urinary tract symptoms such as difficulty starting or stopping urination, a weak stream, frequent urination (especially at night), and incomplete bladder emptying. Advanced disease may present with blood in the urine or semen, erectile difficulty, and, where it has spread to bone, with bone pain.

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Screening for prostate cancer is used to catch the disease before progression has reached later stages in order to maximize treatment outcomes.

PSA

Prostate specific antigen (PSA) is a glycoprotein secreted into the cytoplasm of benign and malignant prostatic cells that is not found in other normal tissues or tumors. Positive PSA screening is not indication in itself of prostate cancer, but should be used in conjunction with other factors like age, prostate size, or other findings. PSA can give false positives with BPH, prostatitis, cystitis, ejaculation, perineal trauma, or recent surgery or instrumentation involving the urinary tract. Additionally, a normal PSA does not rule out prostate cancer as well. For these reasons, PSA is not used as a screening diagnostic in Australia, but is done on an individual basis.

Digital Rectal Exam

Insertion of a finger into the male rectum to palpate the rectum and prostate.

Cystoscopy

Fiberoptic visualization of the bladder.

Sonogram

Endorectal (transrectal) sonogram of the prostate.

Biopsy

Needle biopsy of the prostate; often performed using ultrasound guidance.

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