Feature Article

Personalising prostate cancer care. Part 1. Advances in diagnosis

Amila Siriwardana, James Thompson, Phillip D Stricker



Recent advances in detection and diagnosis of prostate cancer include updated guidelines on PSA testing and early management, multiparametric MRI, transperineal biopsy, genetic testing of tumours and a simplified grading system.

Key Points

  • Prostate cancer is the second most commonly diagnosed cancer in Australian men and has potentially significant implications for quality of life.
  • Updated Australian guidelines on prostate-specific antigen (PSA) testing and early prostate cancer management were published in 2016.
  • Multiparametric MRI of the prostate has an emerging, important role in both prostate cancer detection and management.
  • Prostate biopsy remains a fundamental component of the diagnostic pathway; transperineal biopsy minimises infection risk and may challenge the ‘gold standard’ of transrectal biopsy.
  • Genetic testing of prostate cancer tissue may help differentiate significant from insignificant cancers.
  • A new prostate cancer classification system has been proposed to simplify the Gleason scoring system.

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