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Urology > Prostate and Testicular Cancer > Flashcards

Prostate and Testicular Cancer Flashcards

1
Q

What is the commonest cancer in males?

A

Prostate

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2
Q

What is the majority age group for prostate cancer?

A

> 65yrs

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3
Q

Why are we now better at picking up prostate cancer?

A

Because more PSA tests are run

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4
Q

Is PSA a screening programme?

A

No

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5
Q

What are the risk factors for prostate cancer?

A

Age
Race/ethnicity - african caribbean men
Georgraphy - western countries
FH - 1st degree x2 risk

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6
Q

Which zone do prostate tumours normally affect?

A

Peripheral

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7
Q

What is the main presentation of prostate cancer?

A

Mostly asymptomatic

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8
Q

How is most prostate cancer diagnosed/picked up?

A

PSA

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9
Q

What is the diagnostic triad for prostate cancer?

A

PSA
Digital rectal examination
TRUS - guided prostate biopsies

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10
Q

Is PSA cancer specific?

A

no it is prostate specific but not cancer specific

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11
Q

What are the signs of prostate cancer locally invasive disease?

A 
Haematuria 
Perineal and suprapubic pain 
Impotence
Incontinence
Loin pain 
Anuria
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12
Q

What are the signs of prostate cancer distant metastases signs?

A 
Bone pain 
Sciatica 
Paraplegia secondary to spinal cord compression 
LN enlargement 
Lymphoedema
Lethargy 
Weight loss
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13
Q

What is the commonest mode of presentation for prostate cancer?

A

Asymptomatic

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14
Q

What are the negatives for prostatic cancer screening?

A

Leads to over-diagnosis and over-treatment

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15
Q

What is PSA specific to?

A

Age

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16
Q

How does PSA vary with age?

A

The younger you are the lower the PSA limit

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17
Q

What causes elevations in PSA?

A

UTI
Chronic prostatitis
BPH
Prostate cancer

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18
Q

What is grading an assessment of?

A

Aggressiveness

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19
Q

What is grading based on?

A

Differentiation

20
Q

Is well differentiated cancers good or bad?

A

Good

21
Q

Is poorly differentiated cancers good or bad?

A

Bad

22
Q

What score is used to sum all grading in prostate cancer?

A

6-10

23
Q

What is staging an assessment of?

A

spreal

24
Q

What are the 3 types of stages?

A

Local spread
Regional
Distant

25
Q

What staging system is used to stage prostate cancer?

A

TNM

26
Q

What investigations are used to stage localised prostate cancer?

A 
PR examination
PSA 
Transrectal US guided biopsies 
CT 
MRI
27
Q

What is the treatment for localised prostate cancer?

A

Watchful waiting
Radiotherapy
Radical prostatectomy
Active surveillance

28
Q

What are the types of radical prostatectomy?

A

Open
Laparoscopic
Robot

29
Q

What is active surveillance?

A

Deference of treatment until absolutely necessary

30
Q

What is watchful waiting

A

Monitoring for progression of next stage disease

For people who are not fit/eligable for Rx

31
Q

What is the treatment for locally advanced disease?

A 
Watchful waiting
Hormone therapy follow by surgery 
Hormone therapy followed by radiation 
Hormone therapy alone 
Intermitted hormone therapy
32
Q

What is standard treatment for locally advanced prostate cancer?

A

Hormone therapy followed by radiation

33
Q

What are the types of hormonal therapy for prostate cancer?

A 
Surgical castration 
Chemical castration 
Anti-androgens 
Oestrogen
LHRH antagonists
34
Q

• The following are reasonable treatment options for low-risk localised prostaste cancer except:

a) External beam radiotherapy
b) Active surveillance
c) Brachytherapy
d) Radical prostatectomy
e) Radical chemotherapy

A

Radical chemotherapy

35
Q

• The following statements about screening for prostate cancer are true except:

a) PSA is the best available screening test
b) Compared with ad-hoc opportunistic PSA testing, screening for prostate cancer is beneficial because it saves lives
c) If screening is advocated, it should be performed for men at risk of prostate cancer rather than the entire male population
d) Screening for prostate cancer is not currently advocated
e) For suspicious cases detected by screening, there is a need to undergo a definitive test to confirm or exclude presence of prostate cancer

A

b. Compared to ad-hoc opportunistic PSA testing screening for prostate cancer is beneficial because it saves lives

36
Q

What is the typical presentation of testicular cancer?

A

Usually a painless lump

37
Q

What are less often presentation of testicular cancer?

A

Tender inflamed swelling
History of trauma
Symptoms from para-aortic LN

38
Q

When is peak incidence of testicular cancer?

A

30 yrs

39
Q

What are risk factors for testicular cancer?

A

Infertility
Atrophic testis
Previous cancer in contralateral testis
FH

40
Q

What are some tumour markers for prostate cancer?

A

Alpha fetoprotein
Beta HCG
LDH/lactase dehydrogenase

41
Q

What is the differential diagnosis for testicular lump?

A

Infection
Epididymal cyst
Missed testicular torsion

42
Q

What are the investigations for testicular cancer?

A

MSSU
Testicular USS and CXR
Tumour markers

43
Q

What is the treatment for testicular cancer?

A

Radical orchidectomy
Followed by surveillance
- adjuvant radiotherapy
- prophylactic chemotherapy

44
Q

What is the commonest type of tumour in testicular cancer?

A

Germ cell tumour

45
Q

How is testicular cancer staged?

A

CT scan chest, abdo pelvis

46
Q

For testicular cancer the main lymphatic spread to regional lymph nodes occurs in which group of lymph nodes?

A

Para-aortic lymph nodes

Urology (13 decks)

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