well we can't prevent all of it certainly control of cardiovascular risk factors is important but PSA because of these are the methods available has got a bit of a new lease of life and it still remains an and part but only a part of the paradigm it's not everything okay I'm running a little over time so I won't go through rectal examination there much ex Cialix cept to say that it remains important I do it for every man I see I don't necessarily expect GPS to do it and I think it's fine if you don't do it if you feel confident with it and you know how to interpret the results it's very useful with experience it becomes easier and you can trust your what you're feeling but if not it's okay and it certainly does help contextualize and interpret the PSA level you're seeing particularly in the context of size so how do we prevent urological cancer well number one don't smoke and beware that the smoker is at higher risk of urological disease so obviously take special care with those patients who are smokers and have urinary symptoms cardiovascular risk factor control isn't very important for general health of course but also for your illogical cancer never ignore a materia and early prostate cancer should not be put in the head in the sand basket because of the results of previous trials were a long way ahead of that now and there is

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