Prostate Cancer Flashcards
What is most common cancer in men
Prostate
2nd most common cause of death in men
Prostate cancer
Epidemiology of Prostate Cancer
> 65 generally
Risk Factors for Prostate Cancer
African or Afro Carribbean
First Degree Relative
HPC1, BRCA1 and 2
Where do prostate cancers tend to be
Peripheral Zone
80% of newly diagnosed prostate cancers are
localised
Prostate Cancer is diagnosed through
opportunistic PSA testing
Tests for Prostate Cancer
Bloods: PSA
PR Exam
Trus Guided Prostate Biopsy
Symptoms of Local Disease in Prostate Cancer
Weak Stream Hesistancy Sensation of Incomplete Empty Frequency Urgency Urge Incontinence Urinary Tract infection
Symptoms of Locally Invasive Disease Prostate Cancer
Haematuria Perineal and Suprapubic Pain Impotent Incontinence Loin Pain Anuria Symptoms of renal failure Haemospermia tenesmus
Metastatic Prostate Cancer Symptoms
Bone Pain Sciatica Paraplegia secondary to spinal cord compression lymph node enlarg lymphoedema Loin pain or anuria Lethargy Cachexia weight loss
Commonest mode of presentation for prostate cancer
Asymptomatic
which protease is tested in PSA testing
Kallikrein Serine Protease
which protease is produced by glands of protease
Kallikrein Serine Protease
Normal PSA range
0-4
Age Related PSA Range for <50
2.5 upper limit
Age Related PSA Range for 50-60
3.5 upper limit
Age Related PSA Range for 60-70
4.5 upper limit
Age Related PSA Range for >70
6.5 upper limit
Elevations in PSA can be due to
UTI Chronic Prostatitis Catheter Ejaculation Recent Urological Procedure BPH Prostate Cancer
If repeat PSA is needed when to recheck
3 weeks
As level of PSA raises as does
cancer probability
What guides treatment of prostate cancer
Gleason Grading of Prostate Cancer
how to stage regional and distal in Prostate cancer
CT
how to stage locally in prostate cancer
PR exam and MR
Treatment for localised prostate cancer
Radiotherapy
Radical Prostatectomy
Types of Hormonal Therapy for Prostate Cancer
Surgical Castration eg Bilat Orchidectomy
Chemical Castration eg LHRH Analogue - Goserelin
Anti Androgens
Oestrogens eg Diethylstilboestrol
LHRH Antagonists do not cause
tumour flare
what inactivates androgens and has direct cytotoxic effect on prostatic epithelial cells
oestrogen
If a patient has low risk localised prostate cancer how to treat
Active Surveillance
Surgery
EBRT
Brachytherapy