Renal & UrologyPending review

Prostate Cancer

An androgen-driven adenocarcinoma that arises mainly in the peripheral zone of the prostate, away from the urethra, which is why it grows silently for years before causing symptoms and why PSA screening is imperfect.

In a nutshell

Prostate cancer arises mainly in the peripheral zone, away from the urethra, so it grows silently for years. Its androgen dependency underlies androgen deprivation therapy. PSA is sensitive but non-specific, which is why mpMRI now precedes biopsy. Spread is classically to pelvic nodes and, via the bloodstream, to bone as sclerotic lesions.

Classic presentation

An asymptomatic older man found to have a raised PSA or a hard, irregular prostate on examination, or an older man presenting with axial bone pain from metastatic disease.

Key points

Prostate cancer arises in the peripheral zone (unlike BPH's transitional zone), which is why it does not cause urinary symptoms until locally advanced.

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Educational content pending clinical review. Not medical advice.