Prostate Cancer Flashcards
where does prostate cancer spread?
inguinal lymph nodes?
bone
prostate cancer is dependent on what to grow?
androgen hormones (testosterone)
prostate cancer is generally what type?
adenocarcinoma
where does prostate cancer generally arise?
peripheral zone of prostate
main risk factors for prostate cancer?
age fam history african/caribbean origin tall stature anabolic steroids
how does prostate cancer present?
can be asymptomatic
can cause lower urinary tract symptoms (hesitancy, frequency, weak flow, terminal dribbling and nocturia)
haematuria
why does prostate cancer not cause weak flow, retention etc as much as benign prostatic hypertrophy?
as benign prostatic hypertrophy arises in central zone to presses on urethra
cancer usually in peripheral zone so doesnt press on urethra as much
other possible features of prostate cancer?
Erectile dysfunction
symptoms of advanced disease or metastasis (weight loss, bone pain etc)
what is PSA?
prostate specific antigen
glycoprotein produced by epithelial cells of the prostate and secreted into semen with a small amount entering the blood
helps thin out semen into a liquid consistency after ejaculation
how is PSA used?
mainly used to check for response to treatment and screen for recurrence of prostate cancer
too high a false positive rate to be really useful in diagnosis as so many things can cause raised PSA
what can cause raised PSA?
BPH prostate cancer prostatitis UTI vigorous exercise (esp cycling) recent ejaculation or prostate stimulation
how does benign prostate feel on examination?
smooth symmetrical slightly soft maintained central sulcus (dip between lobes) may have generalized enlargement in BPH
how does infected/inflamed prostate feel on examination?
enlarged
tender
warm
what does prostate cancer feel like on examination?
firm/hard asymmetrical craggy or irregular loss of central sulcus can have a hard nodule
if any features suggestive of cancer are found on examination, what is done?
urgent referral (2 week wait rule) to urology
