Prostate

Question 1

What type of cancer is prostate cancer?

Answer 1

Adenocarcinoma

Question 2

RF for prostate cancer

Answer 2

increasing age
afrocarribean
FH
BRCA gene mutations

Question 3

complications of prostate cancer?

Answer 3

local invasion
mets: especially to bone- fractures and SCC
LUTS

Question 4

Diagnosis of prostate cancer?

Answer 4

History: back pain, bone pain, haematuria, weight loss, FHX

DRE: hard craggy prostate

PSA: increasing or elevated age specific PSA

Question 5

What needs to be mentioned in PSA counselling?

Answer 5

80% of over 80 will have, PSA is not specific to cancer (raised in uti, sex, bph)

raised PSA does not equal cancer and normal doesnt exclude cancer

POsitive results will have to be investigated which means trus biopsy and maybe treatment of an indolent ca that otherwise would have caused no trouble

Question 6

Who is PSA recommended in?

Answer 6

men >50 who ask
men with a family hx
men with unexplained symptoms that could be caused by disease

Question 7

How is diagnosis confirmed in secondary care?

Answer 7

TRUS biopsy
-done under LA, 10 biopsies? risks sepsis, bleeding, may need repeating

MRI usually done if high suspicion and biopsy negative

Question 8

What is a gleason score?

Answer 8

based on microscopic appearance, primary grade 1-5 and secondary grade 1-5

<6 is not considered cancerous

Question 9

RIsks of radical prostatectomy?

Answer 9

urinary incontinence, ed, incomplete resection. all incr in risk after previous radiotherapy

Question 10

How long does goserelin work for and what is it?

Answer 10

GnRH agonist, results in downregulation in testosterone but only works for 18 mo

Question 11

Where do most prostate cancers occur?

Answer 11

peripheral zone