Cancer of the Prostate Flashcards
What is the prevalence of prostate CA?
1/7 men
1/6 diagnosed die
What are RFs for prostate CA?
- Strong family hx (#1)
- Environmental
- Dietary
- High serum testosterone
Prostate CA responds to…
hormonal deprivation
Men castrated before puberty…
do not develop prostate CA
What are signs & sx of prostate CA?
- Early: none
- Late: obstructive sx
- Later: metastatic sx
What are the general principles of the digital rectal exam?
- Hard nodules –> biopsy
- Questionable nodules –> PSA
What is the purpose of the DRE?
- Check prostate
- Check for blood in stool
- Detect rectal CA
What is prostate specific antigen? (PSA)
Serine protease
What produces PSA? Where is it secreted?
- Produced by epithelial cells lining acini & ducts of prostate gland
- Secreted in seminal fluid, very little should enter circulation
- Liquefaction of seminal coagulum
Where is PSA found?
- Normal prostatic tissue
- BPH tissue
- Primary & metastatic prostate CA
What benign conditions can cause elevation of PSA?
- Acute urinary retention
- BPH
- Prostatitis
- Prostatic infection
- Prostatic intraepithelial neoplasia (PIN)
- Instrumentation or catherization
What is PSA velocity? What may it detect?
- Change in PSA over a period of time
- May detect early prostate CA before other methods
What is PSA density?
Serum PSA divided by prostate volume
- >.15 may be significant
PSA density is helpful in…
differentiating prostate CA from BPH
What are 2 categories of genomic testing?
- PCA 3
- 4K Score
