Question 1

An older male patient reports urinary frequency, back pain, and nocturia. A dipstick urinalysis reveals hematuria. What will the provider do next to evaluate this condition?&#10;A) Order a PSA and perform a digital rectal exam (DRE)&#10;B) Refer for a biopsy&#10;C) Refer the patient to a urologist&#10;D) Schedule a transurethral ultrasound (TRUS)

Accepted Answer

Ordering a PSA (Prostate-Specific Antigen) test and performing a digital rectal exam (DRE) are initial steps in evaluating symptoms that could be indicative of prostate issues, such as benign prostatic hyperplasia or prostate cancer, which can present with urinary frequency, back pain, nocturia, and hematuria.

Question 2

A patient is diagnosed with prostate cancer and diagnostic testing reveals disease that has gone past the prostatic capsule without evidence of metastasis. The patient does not wish to undergo treatment. What will the provider tell this patient?

A) Chemotherapy is indicated to provide cure for this cancer.
B) Monitoring prostate-specific antigen (PSA) with regular digital rectal examination (DRE) is an acceptable option.
C) Palliative radiation therapy is necessary to improve quality of life.
D) This level of disease requires intervention with hormonal therapy.

B

Accepted Answer

Monitoring PSA with regular DRE is an acceptable option for patients who do not wish to undergo treatment for prostate cancer that has gone past the prostatic capsule without evidence of metastasis. This approach is known as active surveillance or watchful waiting, and it involves close monitoring of the cancer with the goal of delaying or avoiding treatment while maintaining quality of life. Chemotherapy is typically not indicated for localized prostate cancer, and palliative radiation therapy and hormonal therapy may be considered if symptoms or complications arise. However, in the absence of symptoms, active surveillance is a reasonable option for patients who prefer not to undergo treatment.

Question 3

An older male patient has a screening prostate-specific antigen (PSA) which is 12 ng/mL. What does this value indicate?&#10;A) A normal result&#10;B) Benign prostatic hypertrophy&#10;C) Early prostate cancer&#10;D) Prostate cancer

Accepted Answer

A PSA level of 12 ng/mL is significantly higher than the normal range (0-4 ng/mL) and is concerning for prostate cancer. However, a biopsy is needed to confirm the diagnosis as other conditions such as benign prostatic hypertrophy (BPH) can also cause elevated PSA levels. Further assessment by a urologist is recommended.

Deck 128: Prostate Cancer