<<forEachTiddler where 'tiddler.tags.contains(context.inTiddler.title)' sortBy tiddler.title ascending write '"*[["+tiddler.title+"]]\n"'>> <<tiddler AutoRefresh with: force>> second most common cancer in adult males in UK most common malignant condition in men over 65 years. ''Risk factors'' increasing age Afro-Caribbean ethnicity ''Features'' bladder outlet obstruction: hesitancy, urinary retention haematuria, haematospermia pain: back, perineal or testicular digital rectal examination: asymmetrical, hard, nodular enlargement with loss of median sulcus ''Management'' ''Localised prostate cancer (T1/T2)'' Treatment depends on life expectancy and patient choice conservative: active monitoring & watchful waiting radical prostatectomy radiotherapy: external beam and brachytherapy ''Localised advanced prostate cancer (T3/T4)'' hormonal therapy: see below radical prostatectomy radiotherapy: external beam and brachytherapy ''Metastatic prostate cancer disease'' - hormonal therapy //Synthetic GnRH agonist// e.g. Goserelin (Zoladex) cover initially with anti-androgen to prevent rise in testosterone (tumour flare via LH release) - start Cyproterone 3/7 before Zoladex //Anti-androgen// cyproterone acetate prevents DHT binding from intracytoplasmic protein complexes //Orchidectomy//