Prostate cancer Flashcards
How common in prostate cancer
Commonest cancer diagnosed in men (>26% male cancers)
How many deaths a year are due to prostate cancer
11,300 deaths/year (2nd commonest in men)
What % of cases are over 65 years old
75%
What is the prognosis of prostate cancer compared to other cancers
LOW MORTALITY COMPARED TO OTHER CANCERS
BUT it’s the second commonest cause of cancer death (because so many people have it)
What are the risk factors for prostate cancer
Age
Race/Ethnicity
Geography
Family History
What race/ethnicity are at high risk of prostate cancer
African or Afro-Caribbean men living in Western countries
What race/ethnicity are at low risk of prostate cancer
East Asian or Asian men living in Western countries
What location is high risk for prostate cancer
Northwest Europe/North America/Caribbean/ Australia
What location is high risk for prostate cancer
Asia/Africa/Central & South America
What are the presenting symptoms of localised prostate cancer
Weak stream Hesitancy Sensation of incomplete emptying Frequency Urgency Urge incontinence Urinary tract infection
What are the presenting symptoms of locally invasive prostate cancer
- 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
What are the presenting symptoms of metastatic prostate cancer
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
What are the investigations for prostate cancer
Diagnostic triad of PSA, digital rectal examination and TRUS-guided prostate biopsies
What is PSA
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.
What does a high PSA tell you
That the prostate is likely to be large but it is NOT SPECIFIC ON CANCER
What is TRUS-guided prostate biopsy
uses a local anaesthetic to take a biopsy of the prostate gland
What should be done before a TRUS-guided biopsy
A MRI is used to guide the biopsy.
What is the function of PSA
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.
What is half life of PSA
2.2 days
What is age related PSA
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.
What the the age related range for <50 years
2.5 upper limit
What the the age related range for 50-60 years
3.5 upper
What the the age related range for 60-70 years
4.5 upper
What the the age related range for >70 years
6.5 upper
