Prostate cancer in a family doctor’s practice

Karolina Krikščiūnaitė1, Karolis Lukoševičius1, Deividas Rimkus1

1Lithuanina University of Health Sciences, Academy of Medicine, Faculty of Medicine, Kaunas, Lithuania 


Prostate cancer is a common malignancy with a worldwide prevalence. The incidence has increased in recent decades, largely due to the increased use of prostate-specific antigen (PSA) assays, although mortality from prostate cancer has remained relatively high during that period. The risk of prostate cancer is increased by a man’s age and family history. Men with prostate cancer usually file their complaints in primary care facilities, although diagnoses are often made during screening. Patients most commonly complain of nocturia, poor urine flow, erectile dysfunction, and visible hematuria. It is often difficult to diagnose the disease based on patients ’complaints, as similar symptoms can be caused by other conditions, such as benign prostatic hypertrophy. In rare cases, PSA has false-positive and false-negative results that affect its clinical utility, but the performance of PSA in the diagnosis of prostate cancer is unquestionable. General practitioners need to properly explain to men about the risks and benefits of PSA testing and encourage testing. Transrectal or transperineal biopsies are performed at a secondary health care facility to diagnose prostate cancer. European regulations for urologists before biopsy should be performed mpMRT.

Keywords: prostate cancer, primary care.