Metastatic prostate cancer Flashcards
definition castrate resistant prostate cancer
Castrate serum testosterone < 50 ng/dL or 1.7 nmol/L plus either:
a. Biochemical progression: Three consecutive rises in PSA at least one week apart resulting in two 50% increases over the nadir, and a PSA > 2 ng/mL
or
b. Radiological progression: The appearance of new lesions: either two or more new bone lesions on bone scan
or a soft tissue lesion using RECIST (Response Evaluation Criteria in Solid Tumours).
Symptomatic progression alone must be questioned and subject to further investigation. It is not sufficient to diagnose CRPC.
risk of fracture on ADT
20% at five years
lifestyle changes for osteoporossi
Some FRAX scores indicate that lifestyle changes should be sufficient to manage the risk of fractures.
These changes might include:
stopping smoking reducing alcohol intake keeping physically active getting enough calcium and vitamin D eating a healthful diet limiting the use of some long-term medications, such as glucocorticoids, whenever possible
FRAX score
Osteoporosis causes the breakdown of bone mass and tissue. By weakening the bones, osteoporosis increases the risk of fractures. A FRAX score can help doctors identify people with a high risk of fractures who may need additional support.
The tool consists of questions relating to 12 factors that can increase the risk of fractures.
These factors are:
age weight height sex smoking history of fractures parental history of fractures presence of rheumatoid arthritis use of glucocorticoid medications having secondary osteoporosis drinking three or more units of alcohol per day bone mineral density
FRAX risk
After you or your doctor fills in all your information on the questionnaire, your FRAX score will be calculated. You’ll receive a 10-year risk percentage of a major osteoporotic fracture and a 10-year risk percentage of a hip fracture.
Your score is then plotted on a graph that suggests whether you should get treatment or make lifestyle changes to manage your risk.
A FRAX score of more than 5 percent for a hip fracture, at age 70 and beyond, means you should consider treatment along with lifestyle changes. A lower FRAX score, but at a younger age, may also require treatment or at least a doctor’s supervision