M R Quinlan1, S Teahan, D Mulvin, D M Quinlan. 1. Department of Urology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland. Mark.Quinlan@ucd.ie
Abstract
BACKGROUND: PSA measurement is important in prostate cancer detection. However, applying cut-off values of >4 ng/ml as indication for biopsy misses 20-30% of tumours. AIMS: To determine the number of patients with prostate cancer and normal age-related PSA, referred for TRUS biopsy due to abnormal DRE alone. METHODS: We reviewed patients referred for biopsy over 12 months. Indication for biopsy included abnormal PSA, abnormal DRE, or both. RESULTS: Four-hundred and sixty-five (465) TRUS biopsies were performed, 209 were positive. Of the 183 (183/209) positive on whom complete data were available, 4 (2.2%) had a normal age-related PSA but an abnormal DRE. CONCLUSIONS: Metastatic prostate cancer remains incurable. Therefore detection of organ-confined and potentially curable disease, is crucial. Though PSA has led to earlier detection, this study emphasises the importance of clinical examination, illustrating a normal PSA cannot eliminate the possibility of cancer. DRE and PSA should be interpreted as being collaborative, not competitive.
BACKGROUND: PSA measurement is important in prostate cancer detection. However, applying cut-off values of >4 ng/ml as indication for biopsy misses 20-30% of tumours. AIMS: To determine the number of patients with prostate cancer and normal age-related PSA, referred for TRUS biopsy due to abnormal DRE alone. METHODS: We reviewed patients referred for biopsy over 12 months. Indication for biopsy included abnormal PSA, abnormal DRE, or both. RESULTS: Four-hundred and sixty-five (465) TRUS biopsies were performed, 209 were positive. Of the 183 (183/209) positive on whom complete data were available, 4 (2.2%) had a normal age-related PSA but an abnormal DRE. CONCLUSIONS:Metastatic prostate cancer remains incurable. Therefore detection of organ-confined and potentially curable disease, is crucial. Though PSA has led to earlier detection, this study emphasises the importance of clinical examination, illustrating a normal PSA cannot eliminate the possibility of cancer. DRE and PSA should be interpreted as being collaborative, not competitive.
Authors: T Mäkinen; T L Tammela; M Hakama; U H Stenman; S Rannikko; J Aro; H Juusela; L Määttänen; A Auvinen Journal: J Urol Date: 2001-10 Impact factor: 7.450
Authors: B Candas; L Cusan; J L Gomez; P Diamond; R E Suburu; J Lévesque; G Brousseau; A Bélanger; F Labrie Journal: Prostate Date: 2000-09-15 Impact factor: 4.104
Authors: Ian M Thompson; Donna K Pauler; Phyllis J Goodman; Catherine M Tangen; M Scott Lucia; Howard L Parnes; Lori M Minasian; Leslie G Ford; Scott M Lippman; E David Crawford; John J Crowley; Charles A Coltman Journal: N Engl J Med Date: 2004-05-27 Impact factor: 91.245
Authors: M R Quinlan; B J O'Daly; M F O'Brien; S Gardner; G Lennon; D W Mulvin; D M Quinlan Journal: Ir J Med Sci Date: 2009-04-15 Impact factor: 1.568