Prostate cancer: The Daily PANCE Blueprint
A 68-year-old male presents with back pain and difficulty urinating. Digital rectal exam reveals a hard, irregular prostate. Serum PSA is elevated. Which diagnostic test should be performed to confirm the most likely diagnosis?
A. CT scan of the pelvis
B. Urinalysis
C. PET scan
D. Transrectal prostate biopsy
E. Bone scan
Answer and topic summary
The answer is D. Transrectal prostate biopsy
Prostate cancer is the most common cancer among men (excluding skin cancer) — as about 1 in 8 men will get it. The most important risk factor for the development of prostate cancer is increasing age. Other risk factors include ethnicity, genetic factors, obesity, tobacco, and a diet high in animal fat. Clinical manifestations may include non-specific urinary symptoms (frequency, urgency, etc), hematuria, bone pain, elevated PSA, and an indurated/asymmetrical prostate with nodules on digital rectal exam. A transrectal prostate biopsy will confirm the diagnosis of prostate cancer.
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