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Prostate cancer is a malignant tumour of the prostate. Most cancers of the…
Prostate cancer is a malignant tumour of the prostate. Most cancers of the prostate are likely adenocarcinomas (of the glandular cells).
Definition
Locally advanced prostate cancer extends beyond the capsule of the prostate and is often asymptomatic when diagnosed
Metastatic prostate cancer most frequently affects the bones, where it causes pain and fragility fractures.
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Complications
Distant metastases: metastasising prostate cancer most commonly spreads to the bones, where it can cause pain, pathological fractures, or spinal cord compression.
Lower urinary tract symptoms (LUTS): early prostate cancer does not usually cause LUTS. By the time prostate cancer causes LUTS, it may be advanced and incurable.
Local invasion can be locally invasive and spread to the seminal vesicles, base of the bladder, urethral sphincter, or side wall of the pelvis.
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Prognosis
second most common cause of cancer death in males in the UK (after lung cancer),
The prognostic risk is calculated taking into account the prostate-specific antigen (PSA) level and staging, which is informed further using the Gleason score.
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Signs and symptoms
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Dribbling – after finishing, a bit more urine may trickle out and stain underpants;
Frequency – having to pass urine more often, most irritatingly at night. Getting up several times a night is common and is called ‘nocturia’;
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Pain or stiffness in the lower back, hips or thighs.
usually asymptomatic in most men, metastases may cause some symptoms
lethargy, anorexia, weight loss
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Management
Assessment- Hx of symptoms, PMHx, DHx, FHx, BMI- weight loss
Examination- Digital Rectal Examination to check prostate shape, size, condition of prostate. prostate may be hard and nodular. However normal examination does not exclude prostate cancer.
Investigations- urine dipstick for blood and glucose. Blood U&Es, LFTs, FBC, Bone profile, PSA
Refer if indicated per results, or uncertainty with diagnosis
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