Prostate Screening

In this episode, urologist Jason Du discuses prostate screening. PSA - to screen or not to screen.

Topics

intro
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case study
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first consult with Mr B.
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rectal examination?
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patient resources
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next steps after testing
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oner year on PSA is increased
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rate of rise is important
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development of mild symptoms
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abnormal rectal examination
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what happens when we refer?
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options for treatment
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PSA testing, how often for low-risk patient?
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high risk prostate cancer diagnosis - what next?
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Surgical options
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robotic surgery - finding the right surgeon
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follow up plans and testing
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take-home messages
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Take home messages

PSA screening does reduce prostate cancer mortality.
Having the discussion even as a single test allows for risk stratification for your patient.
There has been a frame shift in how we approach men with elevated PSA. Multi-parametric MRI rather than straight to prostate biopsy, with the aim of improving detection and reducing harm.
Management has changed with a focus on reducing harm. Active surveillance for low-risk patients.
Treatment for intermediate and high-risk patients in now very successful.

Resources

Testing for prostate cancer: helping the patient to decide bpacnz (2020)
Patient advice Kupe.net.nz
PSA test: decision aid OPtion Grid Ebesco
Prostate cancer: diagnosis and management NICE (2019)

Patient Resources

Presenter

Jason Du

Urologist & Urology Surgeon

Jason is a New Zealand trained urologist and urologic surgeon with a special interest in urologic oncology. Jason also has extensive experience in managing kidney stone disease, benign prostatic hyperplasia (the enlarged prostate) and provides a full range of general urological services.