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NURSING 2005_Prostate Cancer_1 Slide PP Flashcards

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1
Q

Front

A

Back

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2
Q

<h1>Page 01</h1>

<br></br>Where is the prostate located?

A

In the pelvis, between the posterior bladder and the anterior rectum.

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3
Q

<h1>Page 01</h1>

<br></br>What is the size of the prostate?

A

About the size of a walnut.

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4
Q

<h1>Page 01</h1>

<br></br>What does the prostate produce?

A

Prostatic fluid, which is a component of semen that protects sperm.

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5
Q

<h1>Page 01</h1>

<br></br>What runs directly through the center of the prostate?

A

The urethra.

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6
Q

<h1>Page 02</h1>

<br></br>What does the superior view of the prostate look like?

A

Please refer to the following link for the superior view of the prostate: http://ar.utmb.edu/webpath/malehtml/male147.htm

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7
Q

<h1>Page 04</h1>

<br></br>What is the stromal component in the prostate?

A

The tissue surrounding the prostatic glands.

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8
Q

<h1>Page 04</h1>

<br></br>What are the main components of the stromal component in the prostate?

A

Fibroblasts, smooth muscle cells, and endothelial cells.

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9
Q

<h1>Page 04</h1>

<br></br>What is the role of the stromal component in the prostate?

A

Regulating prostatic microenvironment, nutrient delivery, and epithelial differentiation.

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10
Q

<h1>Page 05</h1>

<br></br>How many glandular zones make up the prostate?

A

Three glandular zones and one non-glandular stromal region.

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11
Q

<h1>Page 05</h1>

<br></br>What are the names of the glandular zones in the prostate?

A

Peripheral zone, Central zone, and Transitional zone.

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12
Q

<h1>Page 05</h1>

<br></br>What is the non-glandular stromal region in the prostate called?

A

Anterior fibromuscular region.

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13
Q

<h1>Page 06</h1>

<br></br>What percentage of prostatic glandular tissue does the peripheral zone contain?

A

Approximately 70%.

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14
Q

<h1>Page 06</h1>

<br></br>Where is the largest area of the peripheral zone located?

A

At the back of the gland, closest to the rectal wall.

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15
Q

<h1>Page 06</h1>

<br></br>During a digital rectal exam (DRE), which surface of the gland is felt by the doctor?

A

The back surface.

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16
Q

<h1>Page 06</h1>

<br></br>Why is it important for a doctor to feel the back surface of the gland during a DRE?

A

Because about 70% of prostate cancers originate in the peripheral zone.

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17
Q

<h1>Page 07</h1>

<br></br>What percentage of prostatic glandular tissue does the Central Zone contain?

A

Approximately 25%.

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18
Q

<h1>Page 07</h1>

<br></br>What structures does the Central Zone surround?

A

The ejaculatory ducts.

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19
Q

<h1>Page 07</h1>

<br></br>What percentage of prostate cancers begin in the Central Zone?

A

Less than 5%.

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20
Q

<h1>Page 07</h1>

<br></br>What is the likelihood of cancers developing in the Central Zone to invade the seminal vesicles?

A

More likely.

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21
Q

<h1>Page 08</h1>

<br></br>What percentage of prostatic glandular tissue does the Transitional Zone contain?

A

Approximately 5%.

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22
Q

<h1>Page 08</h1>

<br></br>What does the Transitional Zone surround as it enters the prostate gland?

A

The urethra.

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23
Q

<h1>Page 08</h1>

<br></br>How does the size of the Transitional Zone change throughout life?

A

It grows, taking up a bigger percentage of the gland.

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24
Q

<h1>Page 08</h1>

<br></br>What condition is the Transitional Zone responsible for?

A

Benign prostatic hyperplasia (BPH).

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25
Q

<h1>Page 08</h1>

<br></br>What percentage of prostate cancers begin in the Transitional Zone?

A

Roughly 25%.

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26
Q

<h1>Page 09</h1>

<br></br>What forms the convex shape of the anterior prostate?

A

Fibromuscular stroma.

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27
Q

<h1>Page 09</h1>

<br></br>What forms a capsule/band around the prostate as it extends laterally and posteriorly?

A

Fibrous component.

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28
Q

<h1>Page 09</h1>

<br></br>What is the function of the muscular component in the anterior prostate?

A

Forcing fluid out into the urethra during ejaculation.

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29
Q

<h1>Page 09</h1>

<br></br>What does the anterior region of the prostate lack?

A

Glandular tissue.

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30
Q

<h1>Page 10</h1>

<br></br>What are the common pathologies of the prostate?

A

Benign Prostatic Hyperplasia (BPH) and Prostate Cancer.

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31
Q

<h1>Page 10</h1>

<br></br>What is the abbreviation for Benign Prostatic Hyperplasia?

A

BPH.

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32
Q

<h1>Page 10</h1>

<br></br>What are the two main pathologies associated with the prostate?

A

BPH and Prostate Cancer.

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33
Q

<h1>Page 11</h1>

<br></br>What is prostatitis?

A

Inflammation of the prostate.

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34
Q

<h1>Page 11</h1>

<br></br>What are the types of prostatitis?

A

Acute bacterial, Chronic bacterial, Chronic (non-bacterial), Granulomatous.

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35
Q

<h1>Page 11</h1>

<br></br>What are the clinical presentations of prostatitis?

A

Pelvic pain and changes in urination (flow changes, increased frequency, urgency).

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36
Q

<h1>Page 11</h1>

<br></br>What is the clinical presentation of acute prostatitis?

A

Infiltration of inflammatory cells.

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37
Q

<h1>Page 12</h1>

<br></br>What is Benign Prostatic Hyperplasia (BPH)?

A

An overall increase in the size of the prostate due to cellular hyperplasia.

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38
Q

<h1>Page 12</h1>

<br></br>How does an enlarged prostate affect the bladder and urethra?

A

It extends upwards into the bladder, pinches the urethra, and obstructs the outflow of urine.

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39
Q

<h1>Page 12</h1>

<br></br>At what age does the prevalence of Benign Prostatic Hyperplasia (BPH) in men begin?

A

Age 40.

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40
Q

<h1>Page 12</h1>

<br></br>What percentage of men experience Benign Prostatic Hyperplasia (BPH) at age 60?

A

60%.

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41
Q

<h1>Page 12</h1>

<br></br>Is Benign Prostatic Hyperplasia (BPH) a form of cancer?

A

No, it is NOT cancer.

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42
Q

<h1>Page 13</h1>

<br></br>What is thought to be multifactorial in the pathogenesis of Benign Prostatic Hyperplasia?

A

The pathogenesis of Benign Prostatic Hyperplasia.

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43
Q

<h1>Page 13</h1>

<br></br>Which hormones bind to receptors in stromal and epithelial cells in the pathogenesis of Benign Prostatic Hyperplasia?

A

Testosterone and Dihydrotestosterone (DHT).

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44
Q

<h1>Page 13</h1>

<br></br>What happens to prostatic tissue upon androgen withdrawal in the pathogenesis of Benign Prostatic Hyperplasia?

A

Prostatic tissue involution.

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45
Q

<h1>Page 13</h1>

<br></br>Which zone experiences hyperplasia of both stromal and epithelial cells in the pathogenesis of Benign Prostatic Hyperplasia?

A

Transitional zone (majority stromal).

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46
Q

<h1>Page 13</h1>

<br></br>What occurs in the pathogenesis of Benign Prostatic Hyperplasia due to DHT being 10x more potent than testosterone?

A

Nodule formation.

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47
Q

<h1>Page 14</h1>

<br></br>What are the lower urinary tract symptoms associated with symptomatic BPH?

A

Storage (irritative) symptoms, frequency, urgency, nocturia, incontinence.

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48
Q

<h1>Page 14</h1>

<br></br>What are the voiding symptoms associated with symptomatic BPH?

A

Slow urinary stream, straining to void, urinary intermittency, terminal dribbling.

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49
Q

<h1>Page 15</h1>

<br></br>What is the most common cancer in men?

A

Prostate cancer.

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50
Q

<h1>Page 15</h1>

<br></br>What are some risk factors for prostate cancer?

A

Age, family history, race, and obesity.

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51
Q

<h1>Page 15</h1>

<br></br>What is the pathogenesis of prostate cancer?

A

It involves the abnormal growth of cells in the prostate gland.

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52
Q

<h1>Page 15</h1>

<br></br>What is the most common type of prostate cancer?

A

Prostatic adenocarcinoma.

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53
Q

<h1>Page 15</h1>

<br></br>What are some clinical manifestations of prostate cancer?

A

Urinary symptoms, bone pain, and erectile dysfunction.

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54
Q

<h1>Page 16</h1>

<br></br>In 2020, where did prostate cancer rank among the most common cancers diagnosed in men worldwide?

A

2nd, after lung cancer.

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55
Q

<h1>Page 16</h1>

<br></br>How many men worldwide were diagnosed with prostate cancer in 2020?

A

Approximately 1,414,259.

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56
Q

<h1>Page 16</h1>

<br></br>Which region had the highest incidence of prostate cancer in 2020?

A

Northern Europe, with an age-standardised incidence rate of 83.4 men per 100,000.

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57
Q

<h1>Page 17</h1>

<br></br>What was the age-standardized rate of prostate cancer incidence in Australia?

A

72.5 men per 100,000.

58
Q

<h1>Page 17</h1>

<br></br>What was the age-standardized rate of mortality burden of prostate cancer in Australia?

A

10 men per 100,000.

59
Q

<h1>Page 17</h1>

<br></br>What percentage of all cancer diagnoses in Australia was accounted for by prostate cancer?

A

8.5%.

60
Q

<h1>Page 17</h1>

<br></br>What percentage of all cancer-related deaths in Australia was equated to prostate cancer?

A

7.2%.

61
Q

<h1>Page 17</h1>

<br></br>Which cancer was the most common cancer of the male reproductive tract in Australia?

A

Prostate cancer.

62
Q

<h1>Page 18</h1>

<br></br>At what age does the risk of prostate cancer sharply increase?

A

After 40 years of age, peaking between 65 - 74.

63
Q

<h1>Page 18</h1>

<br></br>How does the risk of prostate cancer in African Americans compare to Caucasians?

A

60% higher in African Americans than Caucasians, with an earlier age of onset.

64
Q

<h1>Page 18</h1>

<br></br>What is the impact of family history on the risk of prostate cancer?

A

Higher risk if present in 1st degree relative.

65
Q

<h1>Page 18</h1>

<br></br>Is high animal fat intake a definitive risk factor for prostate cancer?

A

Not definitive.

66
Q

<h1>Page 18</h1>

<br></br>Is cigarette smoking a definitive risk factor for prostate cancer?

A

Not definitive.

67
Q

<h1>Page 18</h1>

<br></br>Are endogenous hormone levels a definitive risk factor for prostate cancer?

A

Not definitive.

68
Q

<h1>Page 19</h1>

<br></br>At what age does prostate cancer typically present?

A

Over 65 years.

69
Q

<h1>Page 19</h1>

<br></br>When is prostatic carcinogenesis thought to be initiated?

A

Earlier than the typical presentation age.

70
Q

<h1>Page 19</h1>

<br></br>What is the term for dysplastic epithelial proliferation thought to lead to prostate cancer?

A

Prostatic intraepithelial neoplasia (PIN).

71
Q

<h1>Page 19</h1>

<br></br>Are PIN lesions considered premalignant?

A

Yes.

72
Q

<h1>Page 19</h1>

<br></br>What is the most common type of primary prostatic tumor?

A

Adenocarcinomas.

73
Q

<h1>Page 19</h1>

<br></br>What is the origin of adeno in adenocarcinoma?

A

Glandular.

74
Q

<h1>Page 19</h1>

<br></br>What is the origin of carcinoma in adenocarcinoma?

A

Epithelial.

75
Q

<h1>Page 20</h1>

<br></br>What may develop after the occurrence of proliferative inflammatory atrophy (PIA)?

A

Prostatic Intraepithelial Neoplasia (PIN).

76
Q

<h1>Page 20</h1>

<br></br>What happens to the epithelial cells lining the acini in PIN?

A

They become abnormal (dysplastic).

77
Q

<h1>Page 20</h1>

<br></br>Where are the abnormalities confined in PIN?

A

To the epithelium.

78
Q

<h1>Page 20</h1>

<br></br>What is considered to be carcinoma in situ?

A

High-grade PIN.

79
Q

<h1>Page 21</h1>

<br></br>Where are both PIN and invasive prostate cancer most frequently located?

A

In the Peripheral Zone.

80
Q

<h1>Page 21</h1>

<br></br>What is the cytologic similarity between HGPIN and invasive cancer?

A

There is cytologic similarity.

81
Q

<h1>Page 21</h1>

<br></br>Are PIN lesions more frequent in prostates with or without cancer?

A

More frequent in prostates that also contain cancer.

82
Q

<h1>Page 21</h1>

<br></br>What markers are found in both HGPIN and invasive cancer?

A

Aneuploidy, expression of oncogenes (bcl-2, c-erb-2, c-erb-3), several growth factors.

83
Q

<h1>Page 22</h1>

<br></br>What percentage of prostate cancers are made up of adenocarcinomas?

A

Approximately 95%.

84
Q

<h1>Page 22</h1>

<br></br>From which zone do around 70% of prostatic adenocarcinomas arise?

A

The peripheral zone.

85
Q

<h1>Page 22</h1>

<br></br>What are the two types of prostatic adenocarcinomas?

A

Acinar (approximately 95%) and Ductal (approximately 5%).

86
Q

<h1>Page 22</h1>

<br></br>How do both types of prostatic adenocarcinomas present?

A

Both tumors present with elevated serum prostate-specific antigen (PSA) levels.

87
Q

<h1>Page 23</h1>

<br></br>What are the characteristics of acinar adenocarcinomas?

A

Cuboidal cells arranged in acini.

88
Q

<h1>Page 23</h1>

<br></br>How are ductal adenocarcinomas composed?

A

Columnar cells arranged in either a papillary or cribriform pattern.

89
Q

<h1>Page 24</h1>

<br></br>How is Prostatic Adenocarcinoma often diagnosed?

A

Via needle biopsy investigating raised serum PSA.

90
Q

<h1>Page 24</h1>

<br></br>What are the macroscopic features of Prostatic Adenocarcinoma?

A

Tan, white, yellow, or orange.

91
Q

<h1>Page 24</h1>

<br></br>When is Prostatic Adenocarcinoma sometimes not visible macroscopically?

A

Sometimes not visible macroscopically.

92
Q

<h1>Page 24</h1>

<br></br>How may the appearance of the prostate differ if the lesion is visible?

A

It may differ in color.

93
Q

<h1>Page 24</h1>

<br></br>What may be visible in the prostate in cases of Prostatic Adenocarcinoma?

A

Nodules.

94
Q

<h1>Page 25</h1>

<br></br>What are the clinical manifestations of early stage prostate cancer?

A

Usually asymptomatic.

95
Q

<h1>Page 25</h1>

<br></br>What are the obstructive/irritative voiding symptoms associated with advanced stage prostate cancer?

A

Intermittent urinary stream, nocturia, urinary hesitancy, decreased force of stream, retention of urine.

96
Q

<h1>Page 25</h1>

<br></br>What are the urinary symptoms associated with advanced stage prostate cancer?

A

Haematuria (blood in urine), haematospermia (blood in ejaculate).

97
Q

<h1>Page 25</h1>

<br></br>What other symptoms may be present in advanced stage prostate cancer?

A

Pelvic pain, renal failure.

98
Q

<h1>Page 26</h1>

<br></br>What is the most common type of prostatic extension (EPE)?

A

Tumor in contact with extra-prostatic fat.

99
Q

<h1>Page 26</h1>

<br></br>Where does local invasion occur in prostatic adenocarcinoma?

A

Into seminal vesicles and bladder base.

100
Q

<h1>Page 26</h1>

<br></br>Why is rectal invasion rare in prostatic adenocarcinoma?

A

Due to tough Denonvillier’s fascia.

101
Q

<h1>Page 26</h1>

<br></br>What is the most common site of metastasis in prostatic adenocarcinoma?

A

Bone.

102
Q

<h1>Page 26</h1>

<br></br>What is the definition of extra-prostatic extension (EPE) in prostatic adenocarcinoma?

A

Tumor in contact with extra-prostatic fat.

103
Q

<h1>Page 26</h1>

<br></br>Which areas can local invasion occur in prostatic adenocarcinoma?

A

Seminal vesicles and bladder base.

104
Q

<h1>Page 26</h1>

<br></br>What prevents rectal invasion in prostatic adenocarcinoma?

A

Tough Denonvillier’s fascia.

105
Q

<h1>Page 26</h1>

<br></br>Where is the most common site of metastasis in prostatic adenocarcinoma?

A

Bone.

106
Q

<h1>Page 27</h1>

<br></br>How is the grade of prostate cancer measured?

A

Using the Gleason system.

107
Q

<h1>Page 27</h1>

<br></br>What does the Gleason score measure?

A

A measure of how abnormal the tissue looks.

108
Q

<h1>Page 27</h1>

<br></br>How is cell differentiation graded in the Gleason system?

A

Graded in two locations with the most predominant tissue patterns visible and given a score between 3 - 5.

109
Q

<h1>Page 27</h1>

<br></br>How is the Gleason Score calculated?

A

Two scores are added together.

110
Q

<h1>Page 27</h1>

<br></br>What is the Gleason Score based on?

A

Solely on the architectural pattern of the tumor.

111
Q

<h1>Page 27</h1>

<br></br>What is the association between higher tissue ‘abnormality’ and cancer aggressiveness?

A

Higher tissue ‘abnormality’ is associated with more aggressive cancer.

112
Q

<h1>Page 28</h1>

<br></br>What is the purpose of the ‘Grade Groups’ in the Gleason System?

A

To simplify prostate cancer grading.

113
Q

<h1>Page 28</h1>

<br></br>When were the ‘Grade Groups’ released as supplementary guidance?

A

In 2014.

114
Q

<h1>Page 28</h1>

<br></br>What is the expected role of ‘Grade Groups’ in the Gleason System?

A

To eventually replace the traditional Gleason System.

115
Q

<h1>Page 29</h1>

<br></br>How is the progression of malignancy summarized?

A

Using the ‘Tumour - Node - Metastasis’ (TNM) staging system.

116
Q

<h1>Page 29</h1>

<br></br>What does the ‘T’ stage represent in the TNM staging system?

A

The local extent of the tumor.

117
Q

<h1>Page 29</h1>

<br></br>What does the ‘N’ stage represent in the TNM staging system?

A

Lymph node involvement.

118
Q

<h1>Page 29</h1>

<br></br>What does the ‘M’ stage represent in the TNM staging system?

A

Any metastases present.

119
Q

<h1>Page 29</h1>

<br></br>What is the TNM system used to stage?

A

A variety of cancers.

120
Q

<h1>Page 29</h1>

<br></br>What factors affect prognosis in cancer?

A

Stage.

121
Q

<h1>Page 30</h1>

<br></br>What is radiotherapy used for in prostate cancer treatment?

A

Local lesions.

122
Q

<h1>Page 30</h1>

<br></br>What are the two types of radiotherapy used in prostate cancer treatment?

A

External beam or implanted radioactive seeds (pellet).

123
Q

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<br></br>What is the goal of hormone therapies in prostate cancer treatment?

A

To reduce the amount of testosterone in the body.

124
Q

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<br></br>How is testosterone involved in prostate cancer?

A

It is involved in the growth and proliferation of cells.

125
Q

<h1>Page 30</h1>

<br></br>When is chemotherapy used in prostate cancer treatment?

A

When metastasis has occurred.

126
Q

<h1>Page 30</h1>

<br></br>What is the goal of surgery in prostate cancer treatment?

A

Prostatectomy.

127
Q

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<br></br>What is the main goal of Androgen Deprivation Therapy?

A

To remove or block testosterone.

128
Q

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<br></br>Why do prostate cells need testosterone to survive?

A

Testosterone is essential for their survival.

129
Q

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<br></br>What will occur in the absence of testosterone in prostate cells?

A

Apoptosis (cell death) will occur.

130
Q

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<br></br>Where is testosterone mainly produced?

A

In the testicles, by Leydig cells.

131
Q

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<br></br>What triggers the production of testosterone?

A

The hypothalamic-pituitary-gonadal axis, involving GnRH, LH, and testosterone.

132
Q

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<br></br>Which stage can be targeted to stop testosterone production/release?

A

Any stage of the hypothalamic-pituitary-gonadal axis.

133
Q

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<br></br>What is the targeted treatment mentioned?

A

Androgen Deprivation Therapy.

134
Q

<h1>Page 32</h1>

<br></br>What is the abbreviation for Gonadotropin-releasing hormone agonists?

A

GnRH agonists.

135
Q

<h1>Page 33</h1>

<br></br>At what age is prostate screening usually recommended for men?

A

Usually for men over 50 years.

136
Q

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<br></br>Under what circumstances is prostate screening commonly done?

A

If symptoms exist or if there is a family history.

137
Q

<h1>Page 33</h1>

<br></br>What is the purpose of a digital rectal examination (DRE) in prostate screening?

A

To palpate the peripheral prostate for abnormalities, asymmetry, and suspiciously hard nodules.

138
Q

<h1>Page 33</h1>

<br></br>What is the usual threshold for elevated levels of prostate-specific antigen (PSA) in a blood test?

A

Usually greater than 4ng/ml.

139
Q

<h1>Page 33</h1>

<br></br>Why is the prostate-specific antigen (PSA) blood test controversial as a solitary detection method?

A

Because it is controversial as a solitary detection method.

140
Q

<h1>Page 33</h1>

<br></br>What are the two types of prostate imaging commonly used in screening?

A

Transrectal ultrasound and MRI.

biology (10 decks)

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