MLAB 320 – Clinical Chemistry III

PSA

Introduction:

There are three common problems affecting the prostate gland. These may be listed
as:

1. Benign Prostatic Hyperplasia

2. Prostatitis
3. Prostatic cancer

1. Benign Prostatic Hyperplasia (BPH)

For most men, during the first 40 years of life, the prostate is on it’s best behavior.
But after 40 years, (80% of men at age 80 years) develop BPH.

BPH is a benign irritating condition that causes the prostate to swell and interfere
with the urine flow. The symptoms are many and may include:

1. Frequent urination.(several times an hour)

2. A sense of urgency.
3. A long wait for urine to flow.
4. Frequent awakening in the night to urinate.
5. Interruption of the urine stream (starting and stopping).
6. A constant feeling of fullness in the bladder.

BPH develops from the inside to the outside. As the inner prostate cells grow, they
begin to squeeze the urethra. For most men, this causes an irritation, but no change
in lifestyle. However, when the squeezing progresses beyond the nuisance point,
(e.g. when it hinders the urine flow, or causes bladder problems) it needs to be
treated.

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 MLAB 320 – Clinical Chemistry III
2. Prostatitis.

Prostatitis is a prostatic condition referring to an inflamed, swollen and tender

prostate. This painful condition may be caused by an infection (bacteria) or by
something else. The symptoms include:

1. Pain in the joints.

2. Pain in the muscles.
3. Pain in the lower back
4. Pain in the area behind the scrotum.
5. Aches fever and chills. (in acute cases)
6. Urinary trouble including blood in the urine (pain or burning with urination)
7. Painful ejaculation.

Bacterial prostatitis in not contagious and cannot be transferred to a man’s sexual

partner. The treatment is to combat the bacteria with antibiotics.

3. Prostate cancer.

What is prostate cancer?

Prostate cancer is an uncontrolled (malignant) growth of cells in the male

prostate gland.

Fig. 3.1 The prostate gland is located at the base of the urinary bladder
surrounding the urethra.

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 MLAB 320 – Clinical Chemistry III
The prostate gland is responsible for helping to a)control urination as well as b)
forming part of the semen. The prostate gland surrounds the passage (urethra)
through which urine from the bladder exits the penis. The normal prostate gland is
the size of a walnut in a young man and enlarges with age.

Normal prostate enlargement is not cancerous and is referred to as "benign prostate

hypertrophy." Both benign prostate hypertrophy and cancer of the prostate can
impinge upon the urethra, leading to difficulty with urination.

In the United States, nearly one quarter of a million males are diagnosed with
prostate cancer annually. Nearly 3% of the deaths among American men are directly
related to prostate cancer (second only to lung cancer and ahead of colon cancer).

Answer the following questions:

1. What is the principle of the test?

2. What are the reagents in the kit?

3. How should the kit be stored?

4. What kind of sample is needed? What can interfere with the test?

5. How are the results reported and what is the clinical significance?

6. Should this test be used as the only test for diagnosis of prostate cancer?

7. Follow the procedure in the handout.

How long should you wait before reading the test?

Past what time should you not read the test?

8. Draw a picture of your test result.

9. Each group of 2 students will discuss one type of treatment for prostate
cancer.