Summary
Definition
History and exam
Key diagnostic factors
- elevated prostate-specific antigen (PSA)
Other diagnostic factors
- abnormal digital rectal exam (DRE)
- nocturia
- urinary frequency
- urinary hesitancy
- dysuria
- hematuria
- weight loss/anorexia
- lethargy
- bone pain
- palpable lymph nodes
Risk factors
- age >50 years
- black ethnicity
- Northern European, Caribbean, Australian, New Zealand, North American, and Southern African populations
- positive family history/genetic factors
- high levels of dietary fat
Diagnostic tests
1st tests to order
- serum prostate-specific antigen (PSA)
- prebiopsy multiparametric MRI
- prostate biopsy
Tests to consider
- prebiopsy biomarker tests and risk calculators
- testosterone
- LFTs
- CBC
- renal function
- bone scan (technetium-99)
- CT scan
- MRI
- prostate-specific membrane antigen (PSMA)-PET/CT
- PSMA-PET/MRI
- tumor molecular and genetic testing
- genetic evaluation and germline testing
Treatment algorithm
very low-risk disease
low-risk disease
favorable intermediate-risk disease
unfavorable intermediate-risk disease
high-risk or very high-risk disease
nonmetastatic disease: postradical prostatectomy
nonmetastatic disease: postradiation therapy
nonmetastatic disease: castration-resistant
metastatic disease: castration-sensitive
metastatic disease: castration-resistant
Contributors
Authors
Timothy J. Wallace, MD, PhD
Radiation Oncologist
Department of Radiation Oncology
Virginia Commonwealth University
Richmond
VA
Disclosures
TJW declares that he has no competing interests.
Mitchell S. Anscher, MD, FACR, FACRO, FASTRO
Professor Emeritus
Department of Radiation Oncology
Virginia Commonwealth University
Richmond
VA
Disclosures
MSA declares that he has no competing interests.
同行评议者
Emma Alexander, MBBS
Clinical Oncology Registrar
St Luke's Cancer Centre
Royal Surrey Hospital
Guildford
Surrey
UK
利益声明
EA has received consultation fees from the following organizations: Blue Cross/Blue Shield Association, Sanofi-Aventis, Ferring Pharmaceuticals, Pfizer Corporation, American Urological Association, National Institutes of Health, Accreditation Council for Graduate Medical Education, Royal Hallamshire Hospital, Hartford County Medical Association. EA owns shares in Pfizer Pharmaceuticals, Johnson and Johnson, and General Electric Corporation.
Peter Albertsen, MD
Medical Director
UConn Medical Group
University of Connecticut Health Center
Farmington
CT
利益声明
PA declares that he has no competing interests.
Patrick C. Walsh, MD
University Distinguished Service Professor of Urology
Professor Emeritus of Urology
Brady Urological Institute
Johns Hopkins University
Baltimore
MD
Раскрытие информации
PCW declares that he has no competing interests.
James Kearns, MD
Assistant Professor of Urology
NorthShore University HealthSystem
Chicago
IL
Раскрытие информации
JK declares that he has no competing interests. JK is an author of an article cited in the topic.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Список литературы
Основные статьи
National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: prostate cancer [internet publication].Полный текст
National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: prostate cancer early detection [internet publication].Полный текст
Parker C, Castro E, Fizazi K, et al. Prostate cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2020 Sep;31(9):1119-34.Полный текст Аннотация
Morgan SC, Hoffman K, Loblaw DA, et al. Hypofractionated radiation therapy for localized prostate cancer: an ASTRO, ASCO, and AUA evidence-based guideline. J Clin Oncol. 2018 Oct 11;36(34):JCO1801097.Полный текст Аннотация
Morgan TM, Boorjian SA, Buyyounouski MK, et al. Salvage therapy for prostate cancer: AUA/ASTRO/SUO guideline part I: introduction and treatment decision-making at the time of suspected biochemical recurrence after radical prostatectomy. J Urol. 2024 Apr;211(4):509-17.Полный текст Аннотация
Morgan TM, Boorjian SA, Buyyounouski MK, et al. Salvage therapy for prostate cancer: AUA/ASTRO/SUO guideline part II: treatment delivery for non-metastatic biochemical recurrence after primary radical prostatectomy. J Urol. 2024 Apr;211(4):518-25.Полный текст Аннотация
Morgan TM, Boorjian SA, Buyyounouski MK, et al. Salvage therapy for prostate cancer: AUA/ASTRO/SUO guideline part III: salvage therapy after radiotherapy or focal therapy, pelvic nodal recurrence and oligometastasis, and future directions. J Urol. 2024 Apr;211(4):526-32.Полный текст Аннотация
Статьи, указанные как источники
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Отличия
- Benign prostatic hyperplasia
- Chronic prostatitis
Больше ОтличияРекомендации
- NCCN clinical practice guidelines in oncology: genetic/familial high-risk assessment breast, ovarian, pancreatic, and prostate
- NCCN clinical practice guidelines in oncology: prostate cancer early detection
Больше РекомендацииЛифлеты для пациента
Prostate cancer
Routine screening for prostate cancer
Больше Лифлеты для пациентаКалькуляторы
Prostatism Symptom Score
Больше КалькуляторыVideos
Male urethral catheterization: animated demonstration
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