Diagnosing prostate cancer - what GPs need to know.

BACKGROUND

The symptoms and signs of prostate cancer usually manifest after it is too late to 'cure' the condition. General practitioners are ideally suited to diagnose this disease early and need to know the latest information about how best to identify and advise patients.

OBJECTIVE

This article describes the latest information about the natural history and detection of one of the commonest cancers in Australian men.

DISCUSSION: Prostate cancer rarely causes symptoms in the early stage and lower urinary tract symptoms (LUTS) are more likely to be due to benign prostate disease rather than cancer. Identifying asymptomatic prostate cancer requires both prostate specific antigen (PSA) and digital rectal examination as about one-fifth of men with prostate cancer have a 'normal' PSA. Although on currently available evidence population screening cannot be recommended, 'case detection' in men deemed to be at risk of prostate cancer is widely practised. Informed patient participation in this process is vital.