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Urology > 1: Urological Malignancies - Prostate Cancer > Flashcards

1: Urological Malignancies - Prostate Cancer Flashcards

1
Q

What is prostate cancer

A

Adenocarcinoma of the prostate gland

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2
Q

What is the commonest cancer in males

A

Prostate cancer

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3
Q

Explain incidence of prostate cancer with age

A

Increases

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4
Q

What are two RF for prostate cancer

A

Smoking

Increasing age

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5
Q

What is the problem with prostate cancer

A

As it occurs in peripheral prostate gland (furthers from ureter) it does not cause symptoms until late

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6
Q

How may prostate cancer present

A
  • Hesitancy
  • Terminal dribbling
  • Poor-Stream
  • Nocutira
  • Back pain (Mets)
  • Weight loss
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7
Q

Explain metastases of prostate cancer

A

Prostatic venous plexus drains to internal iliac veins. However, it also has a branch to posterior venous plexus (Baston venous plexus) which drains to inner vertebral venous plexus causing early mets to the back

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8
Q

How does prostate cancer present on exam

A

hard, irregular (craggy) prostate

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9
Q

What lymph nodes does prostate cancer first spread to

A

Obturator nodes

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10
Q

What two initial investigations are ordered/performed for prostate-cancer

A
  • DRE

- PSA

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11
Q

what is prostate specific antigen produced by

A

Both malignant and non-malignant cells of the prostate gland

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12
Q

when do NICE recommend individuals should be sent under 2WW for prostate cancer

A

50-70 and PSA of more than 4

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13
Q

how long after treatment for UTI or prostatitis should you wait before doing a PSA if required

A

1W

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14
Q

how long should an individual not ejaculate or exercise for if having a PSA test

A

48h

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15
Q

give 5 causes of raised PSA, aside from prostate cancer

A
  • BPH
  • Exercise
  • Ejaculation
  • Instrumentation tract
  • DRE
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16
Q

explain measuring PSA and DRE

A

Do not mausre PSA immediately after DRE - as it causes false positives

17
Q

When are men referred under 2WW

A

50-70 year-olds with

  • PSA >4
  • and abnormal DRE
18
Q

If referred under 2WW for prostate cancer what is now first-line investigation

A

Multiparametric MRI

19
Q

If an individual scores more than 3 on multi-parametric MRI what is offered

A

Trans-rectal US and biopsy

20
Q

If an individual scores 1-2 on multi parametric MRI what Is done

A

Consider TRUS and biopsy depending on:

  • DRE
  • PSA
  • RF
21
Q

what is used to stage prostate cancer

A

Multiparametric MRI

22
Q

what investigation is used to grade prostate cancer

A

Transrectal US and biopsy

23
Q

what scoring system is used to grade prostate cancer

A

Gleason scoring system

24
Q

explain gleason scoring system

A

Most common type of cell is given a score 1-5. The second most common type is given a score 1-5. These are added together to give score 2-10.
10 = worst prognosis

25
Q

how can T1-T2 prostate cancer be managed

A
  • Watchful waiting
  • Prostatectomy
  • Radiotherapy (Brachytherapy, External-Beam)
26
Q

how can T3-T4 prostate cancer be managed

A
  • Hormonal
  • Radiotherapy
  • Radical prostatectomy
27
Q

what is a complication of prostatectomy

A

Erectile dysfunction

28
Q

what is a complication of brachytherapy or external-beam radiotherapy in prostate cancer

A

colon, bladder and rectal cancer

29
Q

what is given to manage metastatic prostate cancer

A

gosrelin

30
Q

what is gosrelin

A

GnRH agonist

31
Q

what needs to be given with gosrelin first and why

A

have to give with a anti-androgen initially to protect against effects of rise in testosterone

32
Q

what is an anti-androgen

A

cytoproterone acetate

33
Q

what is the flare effect

A

during initial stages of treatment with gosrelin it can worsen symptoms due to increase in LH prior to receptor down-regulation

34
Q

what can be given to reduce flare effect

A

flutamide

35
Q

how long should you wait after DRE before doing a PSA

A

1-week

Urology (14 decks)

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