Prostate cancer

• Facts:
  MC cancer in men
  Second leading cause of cancer death in men (after lung cancer )
  Annual DRE after age 50 is recommended screening
• History / PE:
  Usually asymptomatic
  Obstructive urinary symptoms
  Back pain (from metastasis)
• Diagnosis:
  Elevated PSA
  Palpable nodule or an area of induration (DRE)
  U/S guided transrectal biopsy (definitive diagnosis)
  Look for mets with CXR and bone scan
• Treatment:
  Radical prostatectomy and radiation therapy
  
  Androgen ablation (eg. GnRH agonists, orchiectomy, flutamide) and chemotherapy for metastatic disease
  
• Notes:
  Radiation therapy for management of progressive pain from mets