Prostate adenocarcinoma is the most common cancer in men in the United States. It is also the second leading cause of cancer mortality after lung cancer.
Screening of prostate adenocarcinoma is highly recommended in men above 50 years old and as early as 40 years old for higher-risk patients. High-risk patients include African-Americans, family history of prostate cancer, or BRCA1/2 mutations. Prostate-specific Antigen (PSA) is the most suitable study for screening.
Prostate-specific antigen (PSA) represents prostatic epithelium. It is used as a screening test and marker for prostate adenocarcinoma recurrence. It is important to exclude other possible causes of increased PSA because it can also be elevated in prostatitis and benign prostate hyperplasia. Those with a PSA above 7 ng/mL should be referred to a urologist. The test should be retaken several weeks later.
Prostate adenocarcinoma is most commonly (70%) found in the prostate's posterior lobe/peripheral zone. 15-20% are found in the central zone and 10-15% are found in the transitional zone.
Prostate adenocarcinoma is seen more commonly in African-Americans.
The risk of prostate adenocarcinoma increases significantly after 50 years of age. Prostate cancer can be seen in 6 out of 10 men older than 65.
Patients with prostate adenocarcinoma can be asymptomatic in the early stage of the disease.
Blood that presents at the end of urination is called terminal hematuria. This symptom usually indicates a problem in the bladder or prostate and can be seen in advanced stages of prostate adenocarcinoma. The underlying disorder can be diagnosed with the help of cystoscopy and urine culture.
Prostate adenocarcinoma patients can experience urinary retention or incontinence due to mass effect. Symptoms include urgency, terminal dribbling, and hesitancy. Benign prostate hyperplasia typically presents with more of these urinary symptoms due to periurethral enlargement.
Advanced prostate adenocarcinoma can lead to metastases which spread via Batson's venous plexus. These bone metastasis to the spine can result in low back pain in patients. Because patients are usually asymptomatic, low back pain is one of the symptoms patients can complain about in the initial diagnosis.
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