Prostate Flashcards
What are the causes of an elevated PSA?
Benign prostatic hyper trophy Prostatitis Prostate cancer Manipulation Androgen supplements
What can lower the PSA?
Hormones
5alpha reductase inhibitors
Herbal remedies
What are the indications for a trans rectal biopsy?
Abnormal PSA
Big rise in PSA
Abnormal DRE
What is the risk if PSA >10?
73%
What are the benefits of the PSA?
Early diagnosis
Higher incidence of confined disease
Low incidence of high grade disease and metastasis
Can predict future risk
PSA cons?
Non specific Anxiety More biopsies Over diagnosis Over treatment
Active surveillance
Because it is slow growing
Avoid or delay side effects
Manage other major health problems
Old
Do checkups and PSA every 6 mo
Radical prostatectomy
Who:
Confined disease, fit for surgery, life expectancy more than 10 years, PSA
Brachytherapy
Who:
Low risk disease
What: high dose, focused radiation
Side effects:
Early: irritation of bladder and urethra
Late: erectile dysfunction, urethral stricture
External beam radiation
Who:
Localized disease
Not candidate for surgery
What: CT scan for treatment planning, daily
Side effects:
None initially
Fatigue
Irritation of bowel and bladder
Long term: erectile dysfunction , bladder complications
Cryosurgery
Who:
Older, other health concerns
All grades of cancer
PSA
Treatment for metastatic disease?
Hormones
Chemotherapy
Radiation palliative
Risk factors for prostate cancer
Testosterone rich environment Family history High fat diet Race (african) Age
Where do prostate cancers typically occur?
Posterior zone (80%)
5alpha reductase inhibitors
Decrease prostate size so helps with symptoms of benign prostate hypertrophy
Risk of erectile dysfunction
Lowers PSA readings
