CANCER- PROSTATE CANCER Flashcards
What are the risk factors of prostate cancer?
AGE (strongest risk factor)
Race
Genetic: 2-3 fold increased risk if a 1st degree relative affected
Androgens
Diet that’s high in fat and red meat
What may protect males from prostate cancer??
Frequent ejaculation
Diet high in lycopenes (tomatoes!!)
Prostate cancers start out as adenocarcinomas. What is an ADENOCARCINOMA? Also seen in other cancers such as breast cancer.
A type of tumour that has a GLANDULAR origin.
This is why we see it in cancers such as breast cancer (this has glands) oesophageal cancer (glands in neck) and prostate cancer (due to prostate gland)
So in prostate cancer it starts in the prostate gland then can metastasise to the bones
Where does prostate cancer usually metastasise to??
The bones
What is grading of prostate cancer based on?
TNM staging
Of Gleason score
What are the symptoms of prostate cancer?
Hesitancy to wee
Post urination dribbling
Increased Frequency
Increased urgency
Nocturia (weeing in the night)
How common is prostate cancer?
It’s the most common cancer in men
Only 32% of all cases actually get diagnosed! men can actually die with it without knowing, the disease can either lay dormant or be very aggressive.
What are the metastatic symptoms of prostate cancer (i.e. if it has metastasised to the bones and lymph nodes)?
Bone pain Hypercalceamia Spinal cord compression sciatica (pain in the sciatica nerve in the leg) Fracture Lymphoedema (swollen lymph nodes)
How can we diagnose prostate cancer?
Digital rectal examination- examiner feels inside rectum for the prostate. Gives us an idea of the size of the prostate, its firmness (how hard it is) and any nodules. Not a very accurate test
PSA level (prostate specific antigen)
Transurethral ultrasound (more accurate than a digital rectal exam, but overall accuracy for cancer detection is low)
CT/ MRI scan- to look for metastases sites
Radio labelled bone scanning: sensitive and specific to detect bone metastases
What is PSA and what can it tell us?
Prostate specific antigen. It is a glycoprotein secreted by prostatic cells to aid the Liquification of semen.
PSA leaks through cancer cell membrane into the circulation!
So with prostate cancer we will see increased PSA levels
How accurate is a PSA level test?
Fairly accurate but Up to 20% of men with prostate cancer will not have raised PSA levels
PSA can also be used to monitor patients before and after treatment to assess their response!! If their PSA level is coming down it means they are responding to cancer treatment :)
one of the treatment options for prostate cancer is “watchful waiting”. What is this?
Used for well-differentiated localised cancer in patients who are elderly who have under 10 years life expectancy or significant co morbidities that may be affected by treatment.
Involves observation and PSA level monitoring but not treatment.
Its basically just leaving the cancer alone as they will probably die of something else before the cancer kills them. Only treat if the cancer progresses.
When is surgery used in the treatment of prostate cancer?
Used for patients with T1 or T2 disease who have at least a 10 YEAR LIFE EXPECTANCY
Surgery for prostate cancer involves a Radical Prostatectomy. what is this?
Removal of the prostate and sometimes the pelvic lymph nodes.
good prognosis: 85% disease free survival at 10 years!!
When is radiation given to prostate cancer patients?
For patients who are not suitable for surgery but had a GOOD LIFE EXPECTANCY and localised disease (not metastasised)
Can also be used as symptom control in advanced disease and bony metastasis
What are the side effects of Radical Prostatectomy (the surgery done in prostate cancer)?
Erectile dysfunction
Incontinence
(can also happen with the radiation treatment but this is less common)