Prostate Cancer

Epidemiology and risk factors (NEJM 2003;349:366)

  • Most common cancer in U.S. men; 2nd most common cause of cancer death in men
  • Lifetime risk of prostate cancer dx ~16%; lifetime risk of dying of prostate cancer ~3%
  • ↑ risk with ↑ age (rare if <45 y), in African Americans, ⊕ FHx, BRCA mutations

Clinical manifestations

  • Most prostate cancers (78%) are asymptomatic and localized at diagnosis
  • Metastatic dis. sx primarily from bone mets: bone pain, spinal cord compression, cytopenias

Screening (JAMA 2014;311:1143; Lancet 2014;384:2027)

  • PSA: 4 ng/mL cut point neither with BPH, prostatitis, acute retention, after bx or TURP, and ejaculation (