7. Prostate carcinoma

Question 1

How common is it?

Answer 1

1 in 9 men in their life time

Question 2

Who does it affect?

Answer 2

More common in older men
More common in afro-caribbean men
Average age of diagnosis is 66

Question 3

What causes it?

Answer 3

Gene mutations caused by environmental factors or inherited mutations eg BRCA1/2
Hallmarks of cancer accumulate –> malignant cell

Question 4

What risk factors are there?

Answer 4

Obesity
FH
Exposure to pesticides

Question 5

How does it present?

Answer 5

LUTS especially haematuria
Effects of distant mets eg bone pain, lymphadenopathy
Weight loss
Erectile dysfunction

Question 6

What signs may the patient have on examination?

Answer 6

Hard, nodular prostate on DRE

Cachexia

Question 7

How would you investigate?

Answer 7

PSA

Question 8

How would you investigate?

Answer 8

PSA
DRE
Urinalysis
FBC, U+Es etc

Question 9

What treatments are there?

Answer 9

Watchful waiting
Radiotherapy
Prostatectomy
Adjuvant therapy eg hormone therapy, chemotherapy

Question 10

What complications are there?

Answer 10

Local invasion to bladder, urethral sphincter, pelvis

Distant metastases to bone –> fractures, spinal cord compression