Week 25

Week 25: Prostate Cancer:

1. What is the upper limit of normal for PSA?

This depends on the patient’s age:

<50 years <2.8 micrograms / L
50-59 years <4.0 micrograms / L
60 – 69 years 70 years <6.5 micrograms / L

2. What benign factors can cause a PSA to be elevated?

Smoking; recent rectal trauma ( PR examination, proctososcpy)

3. Surgery, radiotherapy, brachytherapy and HIFU are all possible radical treatments for prostate cancer. What do you know about brachytherapy and HIFU?

Prostate Brachytherapy is the use of radioactive sources implanted directly into malignant tissue. Radioactive decay occurs, releasing radiation into the surrounding structures, causing tumour cell death. In prostate cancer, Iodine 125 implants can be placed into the prostate using ultra-sonic guidance. The implants are permanently left in the gland, where over 9 months radiation kills the cancerous cells. This avoids surgery (prostatectomy) and ideally has less side effects as a result.

HIFU is High Intensity Focused Ultrasound, which causes a dramatic increase in temperature in the prostate, up to 85-100 degrees C. This high temperature causes cell death and hence tumour kill. It is only suitable for certain patients however, e.g. those with localised disease. Nor is it a technique available in all hospitals. Click on the word HIFU above to see more illustration and detail.

Conventional surgery (prostatectomy) and external beam radiotherapy remain common treatments for this disease.

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