Prostate Cancer Flashcards
Define Prostate Cancer
Malignant tumour of glandular origin, situated in the prostate
Aetiology of Prostate Cancer
Unknown
Adenocarcinoma is the most common form of prostate cancer
Suggested:
- High fat diet
- Genetic factors
- Hormonal contribution
Lymphatic spread occurs first to the obturator nodes and local extra prostatic spread to the seminal vesicles is associated with distant disease.
Risk Factors for Prostate Cancer
Age >50 Afro-Caribbean/black ethnicity Family history of prostate cancer BRCA2 gene High fat diet
Epidemiology of Prostate cancer
Most common cancer in males, 6th leading cause of cancer mortality overall
Median age of diagnosis was 66
Black men have the higher incidence
Symptoms of Prostate Cancer
Asymptomatic in most/early stages
LUTS
- Storage: Frequency, urgency, nocturia,
- Voiding: hesitancy, dribbling, straining, intermittency, dysuria
Pain
Bone pain, weight loss, lethargy, spinal cord compression (mets)
Urinary retention/renal failure
Haematuria
Signs of Prostate Cancer
Haematuria
Palpable lymph nodes
Investigations for Prostate cancer
Multiparametric MRI: diagnosis
DRE: palpable prostate
PSA: raise >4 Testosterone: normal LFTs: normal FBC: normal, anaemia if mets Renal function: normal, failure in advanced disease
TRUS prostate: malignant cells detected in one or more biopsy specimens
Bone scan and plain X-rays: ?mets
Pelvic CT/MRI: enlarged prostate and lymph node enlargement
What can cause a raised PSA
BPH Urinary retention Urine infection Catheterisation/instrumentation of urethra Prostate cancer (DRE)
What is the staging score used for Prostate Cancer
Gleason score
2 largest areas of tumour found are scored (1-5, 1 is least aggressive, 5 is most)
Two scores quoted AND sum of the two score (e.g. 3+3, 6)
Sum = 2-4 low grade
Sum = 5-7 intermediate
Sum = 8-10 high grade
