Pearls_10

Question 1

Patient presents to clinic and inquires about prostate cancer screening ->

risk factors include increasing ___
___ race
history of ___ cancer in a first-degree relative

Answer 1

age
black race
h/o prosate ca in first degree relative

Question 2

What is the routine screening for prostate cancer? What is it based on?

Answer 2

-> remember routine screening is no longer recommended and is controversial -> should be based on individualized discussions with patients regarding risks/benefits.

Question 3

Routine prostate cancer screening is no longer rec’d (and can be controversial) –> but patient desires screening after discussion

What do you do? (give two options)
- what do you do if positive or high #?

Answer 3

PSA (more sensitive) or digital rectal exam -> if positive DRE or high PSA -> recommend transrectal biopsy (definitive diagnostic test)

Question 4

Patient wanted prostate cancer screening –> his PSA >10 and a Gleason >7 (high risk)

What does he need? (name two images)
What does he need if ca is found to localize to the prostate? (name two options in addition to what type of therapy)?

What if cancer was metastatic, he would still get ___ ___ therapy

Answer 4

• > needs bone scan and CT AP
• > cancer is found to be localized to the prostate* -> needs prostatectomy vs radiation therapy and also androgen deprivation therapy

If metastatic, he would still get androgen deprivation therapy

Question 5

androgen deprivation therapy is for what pt and what would the DxM/Lab findings be that warrants this?

Answer 5

part of the therapy for prostate cancer
(in addition to prostatectomy vs radiation therapy)

warranted as the bone scan and CT AP showed prostate ca loclaized to the prostate

Question 6

FROM MKSAP (prostate ca)
·  Patients with low-risk PSA. What do you do for them?

Answer 6

low-risk (PSA) –> observation

Question 7

FROM MKSAP (prostate ca)
·  Patients with organ-confined prostate cancer and a life expectancy greater than 10 years may be offered radical \_\_\_, \_\_\_ therapy, or active \_\_\_ with the intention to cure.

Answer 7

prostatectomy
radiation therapy
active surveillance

Question 8

FROM MKSAP (prostate ca)
• Patients with *high-risk, locally advanced, or metastatic disease* are treated with \_\_\_ deprivation therapy

• those with hormone-refractory metastatic prostate cancer may benefit from treatment with___

Answer 8

androgen deprivation therapy

chemotherapy