Clinical Knowledge Flashcards
Tumor localized to prostate and not felt on DRE
T1
Tumor is localized and detectable on DRE
T2
Locally advnaced disease w extracapsular
T3
Cancer has advnaced to local strutures
T4
What is the PSA threshold for concern
4
Two types of BX
- transperineal2. transrectal
Gleason 6 risk
low
Immediate/favorable gleason
7 3+4
Intermediate/non-favorable
4 + 3
High Gleason Score
8
Very high Gleason
10-Sep
Describe targeted tissue after ablation
Fibrotic
Thickening of the rectal wall caused by abnormal heating
Symp[tomatic Edema
What does levels of “red” mean on Hausdoff Distance Scale
less similar
what does levels of “blue” mean on Hausdoff Distance Scale
More simular
MRI image that splits body between left/right vertical side view
longitudinal
MIR Image that devidesthe body from head to tail, horizontal plane from top down
transverse
Gland that produces seminal fluid
prostate
Prostate location 2
- behind pubis2. infront of rectum
PSA less than 10Gleason 6 or less ANDStage T1c/T2a
low rish
PSA between 10 and 20Gleason 7 ORT2b
Medium risk
DX PSA Greater than 20Gleason 8 ORT2c/T3
High Risk
used to predict the aggressiveness of cancer from BX
Genomic test
Low Risk on Decipher Scale
0-.45
High Risk on Decipher Scale
.6-1
Identifies enlarged nodes or abnormalities
CT + PET
Can detect evidence of spread to nodes and bones
MRI
stageHalf or less of one glandMore than half of lobe but not both sidesCancer found in both lobes
T2
stageCancer spread through capsule, not into the SVSpread to both sides
T3
stageCancer found in bladder neck, external sphinxtor or rectumSpread to pelvic floor/wall
T4
The lowest point narrow of prostate at sphincter
anatomyical apex
Widest point of the prostate against the inferior surface of the bladder
base
4 potential reasons for a high PSA and no cancer
- UTI2. Stimulation3. Exercise4. medication
How much can the MRi underestimate tumor size
6-9 mm
Active survallience patient type
- Low risk disease2. more t han 10 years to live3. Young and active
T3b
SV inclusion
T2c
Both sides of prostate have disease
T2b
More than half, but not on both lobes
T2a
Half or less one side
T1c
Found on both lobes
What does Gleason Score represent
Agressivness of disease
Howq is the Gleason score determined from BX
Ranges 1-5 and dscribes how much disease is in each core
What do pathologists look for when grading BX cores
- abnormal growth2. Uncontrolled Proliferation of cells
Gleason 1
slow growing, non-aggressive cancer
Gleason 2
- shows more space between glands2. slight irregularity3. slow growing
Gleason 3
Intermediate forma of cancer, not aggressive
FIrst number on Gleason represents
most prevelont form of cancer
second Gleason number represents
Less prevelant form of cancer
Gleason score for active survallience
less than 63 + 4
Gleason score requiring immediate therapy
4+3 or above 8
What does a 4K test measure
cancer aggressiveness
Workflow for elevated PSA
- re-test2. MRI/4K test3. Targeted BX
Used to optimize the size of ablative lesion, while perserving rectum and surrounding structures
HIFI parameters
Tempature that destroys tissue C
80-95
Walnut size gland that produces seminal fluid
Prostate
What percentage of lesions are located in posterior prostate
80