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Title: Understanding the diagnosis of prostate cancer.
Epworth Authors: Ong, Xuan Rui Sean
Bagguley, Dominic
Lawrentschuk, Nathan
Other Authors: Yaxley, John
Azad, Arun
Murphy, Declan
Keywords: Biopsy
Magnetic Resonance Imaging
Positron Emission Tomography
EJ Whitten Prostate Cancer Research Centre at Epworth, Melbourne, VIC
Urology and Vascular Clinical Institute, Epworth HealthCare Victoria, Australia
Issue Date: Nov-2020
Publisher: Wiley
Citation: 213 (9), pp.424-429
Abstract: Prostate cancer continues to be the most commonly diagnosed cancer, and the second leading cause of cancer death among Australian men. Prostate-specific antigen testing is personalised (not dichotomous in nature) and its interpretation should take into account the patient's age, symptoms, previous results and medication (eg, 5-α reductase inhibitors such as dutasteride). Multiparametric magnetic resonance imaging of the prostate has been proven to have a 93% sensitivity for detecting clinically significant prostate cancer. It has the potential to decrease unnecessary prostate biopsies by around 27%. International Society of Urological Pathology (ISUP) grade 1 (Gleason score 6) has been shown to have very little, if any, risk of metastasis ISUP grade 1 (Gleason score 3 +3 = 6) and low percentage ISUP grade 2 (Gleason score 3 + 4 [< 10%] = 7) can be offered active surveillance. The goal of active surveillance is to defer treatment but is still curative when required. With better imaging (magnetic resonance imaging and emerging prostate-specific membrane antigen positron emission tomography-computed tomography) and transperineal prostate biopsy, more men can be offered screening after discussion of risks and benefits, knowing that overdiagnosis has been minimised and radical treatment is reserved for only the most aggressive disease.
DOI: 10.5694/mja2.50820
PubMed URL:
ISSN: 0025-729X
Journal Title: Medical Journal of Australia
Type: Journal Article
Affiliated Organisations: University of Melbourne, Melbourne, VIC
University of Queensland, Brisbane, QLD
Royal Brisbane and Women's Hospital, Brisbane, QLD
Peter MacCallum Cancer Centre, Melbourne, VIC
Type of Clinical Study or Trial: Review
Appears in Collections:Cancer Services

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