16. Prostate Cancer

Question 1

Recall 2 genes that have been implicated for increasing prostate cancer risk

Answer 1

PTEN

BRCA2

Question 2

What sort of gene is PTEN and what is the function of its gene product?

Answer 2

Tumour suppressor

Antagonises androgen signalling

Question 3

Recall 2 implications of a dysfunctional PTEN gene product

Answer 3

1. Androgen-independence of tumour

2. Anti-apoptotic pathway stimulation

Question 4

Where is the most common site of solid-tumour metastasis of a prostate tumour?

Answer 4

Liver

Question 5

What normally confines PSA to the prostate?

Answer 5

Basement membrane and basal cell layer

Question 6

What is the lower boundary of serum PSA to indicate investigation?

Answer 6

4ng/mL

Question 7

Recall 4 non-malignant causes of raised PSA

Answer 7

1. Mechanical - eg cycling
2. Benign prostate hyperplasia
3. Prostatitis
4. Middle age growth spurt

Question 8

What is the scoring system used for staging prostate cancer?

Answer 8

Gleason score

Question 9

What ligand is used in PET scanning?

Answer 9

Radio-labelled fructose

Question 10

Recall a advantage and disadvantage of using X rays in prostate cancer investigation

Answer 10

Ad: quick, no waiting list, easy
Dis: can’t see if bones have mets

Question 11

What is the normal surgical method used for radical prostatectomy?

Answer 11

TRUP

Question 12

What drugs make up the usual treatment course for prostate cancer? Recall the logic behind using both of these

Answer 12

LHRH agonist: hyperstimulates hypothalamus to exhaust it

Androgen antagonist: antagonises remaining adrenal androgens

Question 13

Which hormone is responsible for prostate tumour growth?

Answer 13

DHT

Question 14

Recall 6 side effects of hormone therapy for prostate cancer

Answer 14

Anaemia
Gynaecomastia
Loss of libido
Osteoporosis
Muscle atrophy
Memory loss

Question 15

Recall the main radiotherapy approach used in prostate cancer

Answer 15

Brachytherapy