Prostate and Urinary Cancer Flashcards

1
Q

where is the prostate located

A

base of bladder and circles the urethra

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2
Q

what is the function of the prostate

A

adds lubricant and fluid to sperm

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3
Q

what are the 3 zones of the prostate

A

transitional, central, peripheral

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4
Q

what age group does prostate cancer commonly affect

A

age 70-75 (is rare under 50)

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5
Q

what is a random risk factor for prostate cancer

A

cadmium batteries

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6
Q

what is a common presentation of prostate cancer

A

lower UTI symptoms, haematuria, haematospermia, bone pain, anorexia, weight loss

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7
Q

what investigations are done for prostate cancer

A

PSA test (high serum), PR, trans-rectal USS

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8
Q

what are abnormal findings from a PR prostate exam

A

asymmetry, nodules, fixed mass

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9
Q

what conditions beside prostate cancer may show an elevated PSA

A

benign prostate hyperplasia, prostatitis, retention, catheterisation

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10
Q

what is the most common type of prostate adenocarcinoma

A

95% multifocal

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11
Q

where do prostate adenocarcinomas locally extend to

A

through capsule –> urethra –> bladder –> seminal vesicles –> autonomic nerves

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12
Q

where does prostatic cancer commonly metastasise to

A

pelvic lymph nodes and skeleton (sclerotic legions)

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13
Q

what scale is used for grading prostate cancer

A

gleason’s: 1-5 (5 worst prognosis)

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14
Q

what investigations are done for staging of prostate cancer

A

bone scan, MRI, CT

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15
Q

what management is done for a confined prostate cancer

A

radiotherapy and surgery if needed

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16
Q

what management is done for metastases of prostate cancer

A

androgen deprivation (hormonal, orchidectomy), steroids, chemo

17
Q

what hormones cause proliferation of prostate cells

A

testosterone/ dihydrotestosterone

18
Q

what drugs reduce testosterone

A

LH receptor hormone analogue Aka GnRH agonists (and anti-androgens)

19
Q

how do LHRH agonists work to reduce testosterone

A

cause transient rise in LH, FSH and testosterone but negative feedback then down-regulates and reduces production

20
Q

what do LHRH agonists need to be covered with in first 1-2 weeks

A

anti-androgens

21
Q

how do anti-androgens work

A

compete with testosterone and DHT on prostate cells

22
Q

name a steroidal anti-androgen and the side effects they cause

A

cyproterone acetate - loss of libido and erectile dysfunction

23
Q

name a non-steroidal anti-androgen and the side effects they cause

A

nilutamide, fultamide, bicalutamide - gynaecomastia, breast pain, hepatotoxity (libido remains)

24
Q

what are common side effects of hormonal treatment to prostate cancer

A

loss of libido, hot flushes, weight gain, gynaecomastia, anaemia, osteoporosis

25
which age group is commonly affected by BPH
affects 75% of men over 70
26
what usually causes BPH
imbalance of hormones - decreases androgens and normal oestrogen
27
what are symptoms of BPH
prostatism: poor stream, overflow incontinence, can't start peeing, dribbling
28
what are treatment options for BPH
1st line alpha blocker eg tamsulosin / 5a reductase inhibitor / surgery
29
what are the main types of urinary tumours
transitional (90%), squamous (9%), 1% adenocarcinomas and sarcomas
30
what are risk factors for urinary cancer
males and smoking (almost as big a risk factor as it is for lung cancer)
31
what is the most common type of transitional urinary tumour and is it malignant
80% are papillary type and of those 50% are malignant (carcinoma or papilloma)
32
what is the 2nd most common type of transitional urinary tumour and is it malignant
non-papillary (20%) and they are all malignant
33
what is seen on a transitional cell urinary biopsy
multi-centric, striated, multiple discrete legions
34
what increases risk of developing transitional cell carcinoma of the bladder
catheter
35
what is urachal adenocarcinoma
remnant of allantois (connected umbilicus to bladder in embryo)
36
how can SSC's develop in the bladder
persistant inflam --> squamous metaplasia