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Urinary > Prostate cancer > Flashcards

Prostate cancer Flashcards

1
Q

How common in prostate cancer

A

Commonest cancer diagnosed in men (>26% male cancers)

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2
Q

How many deaths a year are due to prostate cancer

A

11,300 deaths/year (2nd commonest in men)

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3
Q

What % of cases are over 65 years old

A

75%

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4
Q

What is the prognosis of prostate cancer compared to other cancers

A

LOW MORTALITY COMPARED TO OTHER CANCERS

BUT it’s the second commonest cause of cancer death (because so many people have it)

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5
Q

What are the risk factors for prostate cancer

A

Age
Race/Ethnicity
Geography
Family History

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6
Q

What race/ethnicity are at high risk of prostate cancer

A

African or Afro-Caribbean men living in Western countries

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7
Q

What race/ethnicity are at low risk of prostate cancer

A

East Asian or Asian men living in Western countries

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8
Q

What location is high risk for prostate cancer

A

Northwest Europe/North America/Caribbean/ Australia

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9
Q

What location is high risk for prostate cancer

A

Asia/Africa/Central & South America

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10
Q

What are the presenting symptoms of localised prostate cancer

A 
Weak stream 
Hesitancy 
Sensation of incomplete emptying
Frequency 
Urgency 
Urge incontinence 
Urinary tract infection
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11
Q

What are the presenting symptoms of locally invasive prostate cancer

A
  • haematuria
  • perianal and suprapubic pain
  • impotence
  • incontinence
  • loin pain or anuria resulting from obstruction of the ureter
  • symptoms of renal failure
  • Haemospermia
  • rectal symptoms including connexus
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12
Q

What are the presenting symptoms of metastatic prostate cancer

A

Born pain or Sciatica

Paraplegia secondary to spinal cord compression

Lymph node enlargement
Lymphoedema, particularly in the lower limbs

Loin pain or an area due to obstruction of the year twos by lymph nodes

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13
Q

What are the investigations for prostate cancer

A

Diagnostic triad of PSA, digital rectal examination and TRUS-guided prostate biopsies

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14
Q

What is PSA

A

Prostate specific antigen

Also known as gamma-seminoprotein or kallikrein-3 (KLK3), is a glycoprotein enzyme encoded in humans by the KLK3 gene. PSA is a member of the kallikrein-related peptidase family and is secreted by the epithelial cells of the prostate gland.

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15
Q

What does a high PSA tell you

A

That the prostate is likely to be large but it is NOT SPECIFIC ON CANCER

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16
Q

What is TRUS-guided prostate biopsy

A

uses a local anaesthetic to take a biopsy of the prostate gland

17
Q

What should be done before a TRUS-guided biopsy

A

A MRI is used to guide the biopsy.

18
Q

What is the function of PSA

A

PSA is produced for the ejaculate, where it liquefies semen in the seminal coagulum and allows sperm to swim freely.

It is also believed to be instrumental in dissolving cervical mucus, allowing the entry of sperm into the uterus.

19
Q

What is half life of PSA

A

2.2 days

20
Q

What is age related PSA

A

The levels of PSA increase naturally with age. So whe taking a sample you need to use the age of the patient and adjust the expected value.

21
Q

What the the age related range for <50 years

A

2.5 upper limit

22
Q

What the the age related range for 50-60 years

A

3.5 upper

23
Q

What the the age related range for 60-70 years

A

4.5 upper

24
Q

What the the age related range for >70 years

A

6.5 upper

25
Q

What can transiently increase PSA

A

UTI

chronic prostatitis

instrumentation (e.g. catheterisation)

physiological (e.g. ejaculation)

recent urological procedure

26
Q

What is the grading of prostate cancer based on

A

The gleason sum socre

27
Q

What is the maximum gleason sum score

A

10

28
Q

For purposes of treatment and prognosis, useful to divide prostate cancer into 4 stages: what are these

A

Localised stage

Locally advanced stage

Metastatic stage

Hormone refractory stage

29
Q

what is treatment for locally advanced prostate cancer

A

Watchful waiting

Hormone therapy followed by surgery

Hormone therapy followed by radiation

Hormone therapy alone

Intermitted hormone therapy (clinical research)

30
Q

What are the hormone therapies available for prostate cancer

A

Chemical castration
Anti-androgens
Oestrogens

31
Q

What do anti-androgens do?

A

Inhibits the androgen receptors

32
Q

How does oestrogen therapy work?

A

Inhibits LHRH and testosterone secretion, inactivates androgens and has direct cytotoxic effect on prostatic epithelial cells

33
Q

What is treatment of Metastatic and Hormone Refractory stage

A

Immediate hormonal therapy
Supportive treatment
Treat extra symptoms

Urinary (13 decks)

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