Problem 21 The routine check-up
A 65-old-man presents for a routine prostate check. He is otherwise healthy and takes no regular medication. There is no family history of prostate cancer. He has mild lower urinary tract symptoms (LUTS) with slightly reduced flow and mild hesitancy. He looks fit and abdominal examination is unremarkable. On digital rectal examination (DRE) the prostate gland feels enlarged with areas of induration on the right side. Perineal sensation and gross lower limb motor function are intact.
A whole body bone scan is performed and is negative.
Answers
Revision Points
Prostate Cancer
Treatment
• Watchful waiting – expectant management for those not likely to be affected by the diagnosis of prostate cancer.
• Active surveillance – deferral of active treatment for patients who may have clinically insignificant or indolent disease. These patients are followed up regularly for signs of progression.
, www.andrologyaustralia.org. – Andrology Australia
, www.auanet.org. – American Urological Association
, www.cancer.org.au. – Cancer Council Australia
, www.prostatehealth.org.au. – Australian Prostate Cancer Collaboration
, www.usanz.org.au. – Urological Society of Australia and New Zealand
, www.uroweb.org. – European Association of Urology