226b PC Flashcards
Prostate Cancer - fxn
makes PSA - serine protease which liquefies seminal coagulants and make semen liquid
aka repro fxn
Prostate Cancer - location?
peripheral zone - acinar adenocarcinomas
PSA
-2 proPSA more specific for PC
PSA >4 = biopsy
baseline in 40’s can predict those who will die of PC (>1 if 40’s need more monitoring)
Prostate Cancer - risk factors
over 65 years old
AA>white>Asia (diet + genetics)
family Hx - most hereditary of all cancers (# of relatives, closeness, age at dx), 15% of all PC cases
Prostate Cancer - how many get it in lifetime?
1 in 6
Prostate Cancer - what imaging is best?
multiparametric MRI scan - sees how quickly water perfuses through tissue (moves more slowly through cancer)
Prostate Cancer - what do you lose in histo view?
no basal layer
TNM staging - Prostate Cancer
T1 not palpable
T2 palpable
T3 spread outside prostate without other organ involvement (fat and ct) except seminal vesicles
T4 invaded rectum or bladder
Prostate Cancer - where does it spread? how?
direct extension, lymph, bone (via blood?)
axial skeleton - hips, spine, shoulders;
asymmetrical - osteoblastic
lymph node and cancer
usually bean shaped and less than 1 cm
round and > 1 cm = cancer
AS - Prostate Cancer
< 10 years, gleeson 2-5 generally, but no validated points to trigger treatment (anxiety, rising PSA, repeat biopsy w. higher grade/volume)
Prostate Cancer - radical prostatectomy patients
younger, healthier are better candidates
if PC returns, can treat with radiation (unlike radiation)
SE: UI, ED
Prostate Cancer - radio therapy
older patients
locally-advanced disease
SE: can’t do surgery after, prostate is there so can lead to another PC, ED, UI, rectal issues
metastatic Prostate Cancer - hormone treatment
PC is testosterone driven
eventually PC becomes resistant
PC - chemo drugs?
cabazitaxel
docetaxel
