10. Carcinoma Of The Prostate

Question 1

What are the risk factors for prostate cancer?

Answer 1

Increased age
Family history
Ethnicity - black>white>Asian

Question 2

Where in the prostate is cancer most common?

Answer 2

Peripheral zone

Question 3

How do patients present in prostate cancer?

Answer 3

Symptoms of UTI
Prostatism or metastatic disease in bone causing bone pain
Raised PSA, biopsy
Opportunistic finding from DRE
Incidental finding at transurethral resection of prostate

Question 4

How is prostate cancer usually found?

Answer 4

Investigation of elevated prostate-specific antigen (PSA)

Question 5

What can cause a raised PSA?

Answer 5

Prostate cancer
Infection
Inflammation
Large prostate
Urinary retention

Question 6

How is prostate cancer diagnosed?

Answer 6

DRE - hard and irregular
Ultrasound
Increased PSA in blood
Biopsy of prostate
Radiographs and bone scans to stage tumour

Question 7

What is the treatment for localised prostate cancer?

Answer 7

Surgery, hormone therapy, radiotherapy

Question 8

What is the treatment for advanced prostate cancer?

Answer 8

Hormonal manipulation as testosterone promotes tumour growth
- surgical castration
- medical castration (LHRH agonists, GnRH agonists)
Palliative care

Question 9

What are the side effects of castration?

Answer 9

Hot flashes
Impotence
Thinning of bones
Diminished muscle mass
Increase in breast size
Weight gain
Mood changes