Diagnosis Dini & Tatalaksana

Kanker Prostat

Dr. dr. Syarif Bakri, Sp.U. SubSpAnd(K).

Departemen Bedah, Divisi Urologi

Fakultas Kedokteran Univ. Hasanuddin
Makassar
2022
Roehrborn CG. Int J Impot Res 2008;20[Suppl. 3]:S11–8.
Benign Malignant
INTRODUCTION
Clinical manifestation (1)
• No symptoms (was detected during annual check up
or screening due to familial history of prostate
cancer)

• LUTS / urinary retention

• Hemospermia
• Hematuria
• Bone pain / pathologic fracture
• Neurological symptoms
Multifactorial aetiology of lower urinary tract
symptoms (LUTS)
 Clinical manifestation (2)

• Abnormality on DRE:
- hard consistency
- uneven surface
- nodule
- asymetrical enlargment

• Abnormality on trans-rectal ultrasonography (TRUS):

- hypo- or hyper-echoic lesion
- Hypervascularisation (Doppler)
Diagrams of hyperplastic prostatic tissue obstructing the prostatic urethra forming “lobes.” A,
Isolated middle lobe enlargement. B, Isolated lateral lobe enlargement. C, Lateral and middle
lobe enlargement. D, Posterior commissural hyperplasia (median bar)

Roehrborn CG.Int J Impot Res 2008;20[Suppl. 3]: S11–8.

ULTRASOUND OF THE PROSTATE (TAUS)
ULTRASOUND OF THE PROSTATE (TRUS)
 Laboratory
• Complete blood count
• Ureum and creatinine
• Urinalysis
• PSA (prostate spesific antigen)
 WHEN TO DO BIOPSY
• DRE finding susp malignancy : hard consitency,
irregularity, nodul, assymetric
• Ultrasonography finding : prostate
calsification, inhomogen
• PSA > 4 ng/dl
TRUS - Biopsy
Prostate cancer in Asia: Treatment modalities

As stated in guidelines from many

institutions/organizations worldwide including from
Asia, treatment options for prostate cancer were
depend on several factors
Treatment option Consideration Factors

Active surveilance Life expectancy at diagnosis

Radical Prostatectomy Tumor grade, PSA

Radiotherapy Tumor stage

Androgen deprivation therapy Co-morbidity

Chemotherapy Patient’s preverence

Thank You