Question of the Week # 72

A 55 y/o african american man with newly diagnosed Stage B prostate cancer undergoes radical prostatectomy and is referred to you from surgical clinic for routine follow up. The patient requests how often he should follow up with you and what tests he would need. Your best response is:

A) You do not need any follow up because you had a local cancer that was completely resected
B) PSA need to be tested every six months for 5 years and thereafter, every year
C) Bone scan to evaluate metastasis is needed every year
D) Digital Rectal Exam every year to look for local recurrence
E) You need endocrine therapy before we proceed further

Question of the Week # 71

Q71) A 65 y/o African American man is brought by his daughter to you and requests a PSA test because there is a hx of prostate ca in their family. You perform PSA and DRE. DRE does not reveal any palpable mass. The lab test reveal : PSA : 8ng/ml, Free PSA: 1.5ng/ml. You reveal the results to patient and his daughter. The daughter asks you if her father has a cancer. Your best response is :

A) The PSA level increases with age and your father’s PSA  is in the  age-appropriate range
B) PSA level is very nonspecific and your father does not have a cancer
C) The fact that the free PSA is only 1.5ng/ml as opposed to a bound of 6.5 indicates that your father most likely has a cancer etiology rather than benign cause
D) PSA will not help in diagnosing carcinoma prostate
E) I did this test only because you requested for it, I do not think this results mean anything.

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