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AUA Score & Prostate Cancer

The American Urological Association Prostate Symptom Score is a seven-question test designed to help a doctor determine the severity of a man's prostate cancer or enlarged prostate (benign prostatic hyperplasia) lower urinary tract symptoms in order to prescribe the best course of treatment for him. The patient fills out the questionnaire and then the doctor reviews the answers with him for accuracy.

  1. Prostate Cancer

    • Prostate cancer is one of the most common types of cancer in men. According to the Mayo Clinic, the prostate is a small, walnut-shaped gland that provides the seminal fluid that grows and transports sperm. It is common for the prostate to enlarge with age, causing many symptoms, including frequent urination and discomfort. Precancerous enlargement, or BPH, frequently develops into cancer of the prostate. It is important to treat BPH and prostate cancer early.

    Purpose

    • According to the Prostate Cancer Research Institute, medical information is frequently reported without objectivity, but "lower urinary tract symptoms (LUTS) of significant degree adversely affect the quality of our lives." Without accurate information about what BPH or prostate cancer symptoms a patient is experiencing or how severe they are, the doctor cannot make the best possible decision for treatment or surgery to improve quality of life.

    Questions

    • How often over the past month have you experienced the following:

      1. The sensation of not emptying the bladder completely?

      2. Having to urinate again in less than two hours?

      3. Stopped and started when urinating?

      4. Found it difficult to postpone urinating?

      5. Had a weak urinary stream?

      6. Had to push or strain to begin urinating?

      7. And how many times did you typically get up to urinate at night?

    Scoring

    • The questions are scored on a scale of zero to five, with zero being never, one to four being one to four accordingly, and five equaling five or more times. A Symptom Index is determined by adding the scores. The highest possible score is 35, which would represent the highest level of pain and discomfort. The Symptom Index falls into three main categories: mild (0 to 7); moderate (8 to 19); and severe, (20 to 35).

    SIgnificance

    • The Prostate Cancer Research Institute reports that objective measurement of LUTS is essential after diagnosis of prostate cancer, especially if the patient has a high Symptom Index before surgery or radiation therapy. "The magnitude of these urinary symptoms will dramatically affect the probability of serious difficulties during and after a particular treatment," the PCRI concludes. For this reason, the AUA and the PCRI strongly recommend doctors use the Prostate Cancer Symptom Score questionnaire.

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