GEM - prostate disease

Benign prostatic hyperplasia (BPH):

Benign prostatic hyperplasia is a common condition in older men and may even be regarded as a natural part of ageing.

• how common is BPH?
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• what are the theories why BPH may occur?
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• what are the clinical features of BPH?
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• if BPH is suspected then what investigations should be initiated in primary care?
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  • regarding a PSA test
    • when undertaking requesting a PSA test, what practical considerations should be made?
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    • the normal values for a PSA test have been defined based on specific age categories. What are these age specific PSA levels?
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• what are the options for medical treatment for patients with BPH?
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• what about the use of herbal treatments such as saw palmetto in BPH?
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Prostatic cancer:

Prostatic carcinoma is the second most common cancer in men in the UK. A quarter of men with cancer of the prostate die of the disease. Those who do not die of cancer may require treatment to ameliorate symptoms such as bone pain and urinary obstruction.

The most common age of presentation is between 65-85 years of age. It is rare before 50 years. The majority are well differentiated adenocarcinomas. Most present with metastatic disease.

Is prostatic cancer the most common cause of cancer death in the UK male population?

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Are symptoms of bladder outflow obstruction present in the majority of patients with prostatic cancer?

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A raised PSA may occur in prostatic cancer.

• What are other causes of a raised PSA?
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• What is the relationship between PSA levels in asymptomatic men and development of prostatic cancer?
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What are the criteria for urgent referral for a case of suspected prostatic cancer?

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If a diagnosis of prostatic cancer is made, what are the management options for organ-confined prostatic cancer?

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Is there any evidence for therapies to prevent development of prostatic cancer?

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Further information from GPnotebook:

• benign prostatic hyperplasia section click here
• prostatic carcinoma section click here
• prostatitis section click here

Reference:

1. Royal College of General Practitioners. Curriculum Statement 10.2 Men's Health.