Exam 2 - Prostate Cancer Weddle Flashcards
prostate cancer is the ____ most common cause of cancer related death in men
a. 1st
b. 2nd
c. 3rd
b. 2nd
Most risk factors associated with prostate cancer
are related to increased exposure to __________
testosterone
T or F: risk of PC is more common in Asians than African-Americans
F (more common in African-Americans)
metastasis to the ______ is the most common natural progression of PC?
a. lung
b. liver
c. bone
c. bone
which Gleason Scores are slow-growing and well-differentiated?
a. 2-4
b. 5-7
b. 8-10
a. 2-4
which Gleason Scores are aggressive and poorly differentiated?
a. 2-4
b. 5-7
b. 8-10
b. 8-10
normal PSA range
0-4 ng/mL
PSA of > _____ ng/mL is highly suspicious for malignancy
a. 0
b. 4
c. 10
c. 10
what do HSPC and CRPC stand for?
HSPC = hormone sensitive prostate cancer
CRPC = castrate resistant prostate cancer
for the localized tx of prostate cancer, observation involves monitoring the course of disease with the expectation to deliver _________ therapy for development of sx or a change in exam or PSA that suggests sx are imminent
palliative
localized tx of PC: in active surveillance, if cancer progressing, will initiate potentially ________ therapy
a. curative
b. palliative
a. curative
which of the following is a disadvantage of active surveillance of PC?
a. ~2/3rds of pts eligible for surveillance will avoid therapy
b. avoids possible SE
c. QOL less affected
d. periodic follow up and tests necessary
d. periodic follow up and tests necessary
tx overview for localized tx of PC (3 of them)
-active surveillance
-radiation therapy
-surgery
radiation therapy for localized tx of PC (2)
external beam vs brachytherapy
for locally advance/high risk pts for PC, what is used in combo with EBRT (external beam radiation therapy)?
ADT (androgen deprivation therapy)
radical prostatectomy + PLND is a ________ therapy
a. palliative
b. curative
b. curative
the goal of ADT is to induce castrate levels of __________
testosterone
ADT involves what two things?
LHRH agonist +/- anti-androgen or orchiectomy
which drug class blocks androgen receptors and inhibits androgen uptake and binding in target tissues?
antiandrogens (part of ADT)
examples of LHRH agonists
leuprolide; -relins
look at toxicities of LHRH agonists (slide 25)
ok
which drug, compared to LHRH agonists, has less CV events?
relugolix
examples of anti-androgens (just the ending)
-lutamides
which anti-androgen has the longest half-life?
a. flutamide
b. bicalutamide
c. nilutamide
b. bicalutamide
(longest half-life; once daily dosing)
first line therapy for metastatic PC:
-goal is to suppress testosterone production < ____ ng/dL
-need to determine whether this is a _____ recurrence or overt metastatic disease
-determine PSA ________ time
< 50 ng/dL
PSA
doubling
for m0HSPC, if pSA doubling time < 6 months:
a. can give ADT
b. can observe
a. can give ADT
what is an orchiectomy?
removal of testes
which drug class has risk of disease flare in the first weeks of therapy due to initial release of testosterone?
LHRH agonists (resolves in 2 weeks)
m0CRPC tx
ADT (leuprolide probably) and add enzalutamide, apalutamide, or darolutamide (least SE)
T or F: abiraterone is used in the M0 setting
F
low volume m1HSPC tx (2 things)
-ADT
-add one of the 3:
abiraterone + prednisone
enzalutamide
apalutamide
why is abiraterone given with prednisone?
to help prevent renal insufficiency
high volume m1HSPC tx differs from low volume because of what?
in high volume we add chemo (docetaxel) + ADT
look at m1CRPC tx, there are many things we can add to ADT (slide 53)
alrighty
m1CRPC first and second line tx includes ?
1st line: docetaxel + prednisone
2nd line: cabazitaxel + prednisone
drug with FDA approval for dMMR/MSI-H cancers
a. pemetrexed
b. apalutmide
c. mitoxantrone
d. pembrolizumab
d. pembrolizumab
what isotope is used for bone metastases?
radium 223 dichloride
drug used for PSMA positive mCRPC
Pluvicto (Lu-177)
what exam is used for prostate cancer screening?
a. DRE
b. PSA
c. MRI
d. CT scan
a. DRE (digital rectal exam)
for men aged 50 or older, PSA level 2.5 or higher, how often should they be screened for PC?
a. every 6 months
b. every year
c. every 5 years
d. every 10 years
b. every year
for men aged 50 or older, PSA < 2.5, how often should they be screened for PC?
every 2 years
drug for prostate cancer prevention
finasteride
