L18 - Prostate cancer Flashcards
1. Describe the common presentations (both anatomical and physiological) of prostate cancer with reference to the role of prostate specific antigen PSA 2. Explain the importance of prostate specific antigen PSA in diagnosis of prostate cancer 3. Natural history of prostate cancer, risk factors and related pathology 4. Identify and describe the investigation and treatment options for prostate cance r(biopsy, bone scan, MRI) and be able to explain why prostate cancer tends to spread to bones 5.
State some examples of common symptoms of prostate cancer in men?
- Urinary complaints or retention
- Back pain
- Haematuria
Describe the position of the prostate?
- Gland lying beneath bladder
- encircles urethra.
Examples of symptoms found in patients with advanced disease?
loads
- Cancer cachexia
- Bony tenderness
- Lower-extremity lymphedema
- Deep venous thrombosis
- Adenopathy
- Overdistended bladder due to outlet obstruction
Cancer cachexia
Wasting syndrome characterised by :
- weight loss.
- anorexia
- asthenia
- anaemia
Asthenia
Abnormal physical weakness or lack of energy
Adenopathy
- Disease of lymph nodes
- abnormal in size or consistency.
- Inflammatory type.
Lymphedema
- Swelling occuring in arms or legs.
- Commonly caused by removal of or damage to lymph nodes as part of a cancer treatment.
State diagnosis methods for prostate cancer
- Elevated prostate-specific antigen PSA level
- Abnormal digital rectal examination findings DRE
- Biopsy
- Screening
What is prostate-specific antigen?
- Protein produced by normal prostate epithelial cells.
- Enzyme, results in liquefaction of ejaculate to increase sperm motility.
- Rising levels of PSA associated with prostate cancer.
Describe the structure and attributes of PSA?
33-kd protein consisting of a single chain glycoprotein of 237 AA residues.
How may a digital rectal examination DRE diagnose prostate cancer?
Most patients diagnosed with prostate cancer may have normal DRE results but abnormal PSA readings.
What are 3 well established risks of prostate cancer?
- Increasing age
- median age at diagnosis is 68 - Ethnicity
- afro-caribbean - Heredity
Describe the staging of tumour node metastasis?
T1c - not palpable on DRE T2 - Palpable on DRE T3 - outside the prostate T4 - Invades surrounding structures N - Lymph nodes M - Metastases
What is the Gleason’s pattern?
Standard approach for grading prostate cancer.
Based on pathologic evaluation of a prostatectomy specimen.
Describe the Gleason’s score?
- Small uniform glands
- More stroma between glands
- Distinctly infiltrative margins
- Irregular masses of neoplastic glands
- Only occasional gland formation.