Carcinoma Of The Prostate

Question 1

What is the most common type of prostate cancer?

Answer 1

Adenocarcinoma (>95% of cases).

Question 2

Which hormone influences the development of prostate cancer?

Answer 2

Testosterone and dihydrotestosterone.

Question 3

What is the Gleason grading system based on?

Answer 3

Glandular differentiation; graded from 1 to 5.

Question 4

What are the main risk factors for prostate cancer?

Answer 4

Age, family history, genetic mutations, smoking, alcohol intake.

Question 5

Which genetic mutations are associated with hereditary prostate cancer?

Answer 5

BRCA2, HPC1 (1q), MSR1 (8p), XP, and Y chromosome mutations.

Question 6

Which zone of the prostate is most commonly affected by cancer?

Answer 6

Peripheral zone (75% of cases).

Question 7

How does prostate cancer typically spread locally?

Answer 7

Through the prostatic capsule, seminal vesicles, bladder, and urethral sphincter.

Question 8

What is the most common site of distant metastasis in prostate cancer?

Answer 8

Bones, particularly the axial skeleton (spine, pelvis, ribs).

Question 9

What type of bone metastases is more common in prostate cancer?

Answer 9

Sclerotic (85%) rather than lytic (15%).

Question 10

What venous system allows direct spread of prostate cancer to the spine?

Answer 10

Valveless prevertebral veins connecting the prostatic venous plexus to vertebral veins.

Question 11

What is the most common clinical presentation of localized prostate cancer?

Answer 11

Asymptomatic; may be detected by elevated PSA or abnormal DRE.

Question 12

What urinary symptoms may indicate prostate cancer?

Answer 12

Hematuria, voiding discomfort, hematospermia, lower urinary tract symptoms.

Question 13

What symptoms suggest locally advanced prostate cancer?

Answer 13

Urinary obstruction, renal failure, malignant priapism, rectal obstruction.

Question 14

What symptoms suggest metastatic prostate cancer?

Answer 14

Bone pain, anemia, jaundice, coagulopathy, weight loss, lower limb swelling.

Question 15

What percentage of prostate cancers are organ-confined at diagnosis?

Answer 15

Only 40% of cases detected by DRE are organ-confined.

Question 16

What is the primary role of Prostate-Specific Antigen (PSA)?

Answer 16

Liquefies ejaculate; produced by prostate epithelial cells.

Question 17

What are the main forms of PSA in circulation?

Answer 17

Complexed/bound PSA (75%) and free PSA (25%).

Question 18

What is a significant PSA threshold for predicting prostate cancer?

Answer 18

PSA > 50 ng/ml is associated with lymph node involvement in 75% of cases.

Question 19

Name three benign conditions that can elevate PSA.

Answer 19

BPH, prostatitis, urethral instrumentation.

Question 20

What drugs can artificially lower PSA levels?

Answer 20

5-alpha reductase inhibitors, anti-androgens, GnRH agonists.

Question 21

What imaging modality is used for prostate cancer staging?

Answer 21

Multiparametric MRI.

Question 22

What is the role of a radionucleotide bone scan in prostate cancer?

Answer 22

Detects bone metastases.

Question 23

What are complications of advanced prostate cancer?

Answer 23

Anemia, spinal cord compression, visceral metastases, renal failure, coagulopathy.

Question 24

What are the main management options for localized prostate cancer?

Answer 24

Watchful waiting, active surveillance, radical prostatectomy, EBRT, brachytherapy.

Question 25

What surgical technique is used for radical prostatectomy?

Answer 25

Open, laparoscopic, or robotic-assisted radical prostatectomy.

Question 26

What is the primary treatment for locally advanced non-metastatic prostate cancer?

Answer 26

EBRT combined with ADT.

Question 27

What are key components of palliative care in advanced prostate cancer?

Answer 27

Pain management, TUR channeling, catheterization, nephrostomy, ADT, radiotherapy.

Question 28

What are the main types of Androgen Deprivation Therapy (ADT)?

Answer 28

Surgical castration, LHRH agonists, anti-androgens, maximal androgen blockade.

Question 29

What is maximal androgen blockade (MAB)?

Answer 29

Combination of LHRH agonists and anti-androgens.

Question 30

Which chemotherapy class is used for metastatic prostate cancer?

Answer 30

Taxane-based chemotherapy (e.g., docetaxel).

Question 31

What is the role of bisphosphonates in prostate cancer?

Answer 31

Prevents bone loss and reduces skeletal-related events in bone metastases.

Question 32

What is the gold standard treatment for symptomatic BPH in prostate cancer patients?

Answer 32

Transurethral Resection of the Prostate (TURP).

Question 33

How does TUR channeling differ from standard TURP?

Answer 33

Creates wider channels for urine flow rather than complete tissue removal.

Question 34

What is the first-line treatment for spinal cord compression in prostate cancer?

Answer 34

High-dose corticosteroids and urgent radiotherapy or surgery.

Question 35

What is the purpose of hemostatic radiotherapy?

Answer 35

Controls bleeding from advanced prostate cancer.

Question 36

What is a common metabolic complication of prostate cancer bone metastases?

Answer 36

Hypercalcemia.

Question 37

What is the significance of free-to-total PSA ratio?

Answer 37

A lower ratio suggests a higher likelihood of prostate cancer.

Question 38

What is the TNM staging system used for?

Answer 38

Classifies prostate cancer based on tumor size, nodal involvement, and metastases.

Question 39

Which patients are candidates for watchful waiting?

Answer 39

Elderly or comorbid patients with low-risk prostate cancer.

Question 40

What is the role of active surveillance?

Answer 40

Monitors low-risk prostate cancer with periodic PSA tests and biopsies.

Question 41

What is the most effective curative treatment for localized prostate cancer?

Answer 41

Radical prostatectomy or radiotherapy.

Question 42

What is the main disadvantage of radical prostatectomy?

Answer 42

Risk of urinary incontinence and erectile dysfunction.

Question 43

What is the role of pelvic radiotherapy?

Answer 43

Treats lymph node involvement in locally advanced prostate cancer.

Question 44

Which patients benefit from intermittent ADT?

Answer 44

Patients with biochemical recurrence but no visible metastases.

Question 45

What is a severe consequence of untreated ureteric obstruction in prostate cancer?

Answer 45

Renal failure.

Question 46

What is malignant priapism?

Answer 46

A rare condition caused by tumor invasion into penile tissue.

Question 47

How can anemia develop in prostate cancer patients?

Answer 47

Bone marrow infiltration or chronic disease effects.

Question 48

What is the first-line imaging for visceral metastases?

Answer 48

Abdominopelvic ultrasound or CT scan.