Prostate CA - radiation perspective

Question 1

what is natural Hx of prostate CA

Answer 1

thought to arise from damaged epithelium

- multifocal cause

Question 2

what does Tx option depend on

Answer 2

1. stage
2. gleason
3. PSA
4. patient factors
   - health, age, feelings about impact

Question 3

what are 5 uses of external beam

Answer 3

1. curative Tx in localied CA
2. in combo with brachy
3. adjuvant or salvage
4. in combo with ADT in high risk
5. Sx control in mets disease

Question 4

what is diff. in effect for different Tx

Answer 4

no sig. diff. found

Question 5

3 main factors predicting recurrence following prostatectomy

Answer 5

1. penetration through capsule
2. seminal vesicle involvement
3. pos. margins

Question 6

what effect of salvage

Answer 6

• benefit for biologic progression free survival

- no benefit for overall survival

Question 7

5 acute side effects of rads

Answer 7

1. tiredness
2. urinary
3. skin
4. epilation
5. rectal

Question 8

5 late SE of rads

Answer 8

1. urinary
2. rectal
3. skeletal
4. skin
5. ED

Question 9

what is role in palliation

Answer 9

85% reduction in pain

Question 10

what are 2 main issues with bone mets

Answer 10

1. higher risk of death

2. higher risk of skeletal related events

Question 11

when to use Radium 223

Answer 11

in Tx of bony mets in ADT resistant therapy

Question 12

what is MOA in radium 223

Answer 12

taken up into bone and A-emmiter

- shorter range of waves and kill

Question 13

what is effect of radium

Answer 13

increased SURVIVAL benefit