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#Phase 2.1: Peri Op > Prostate Cancer > Flashcards

Prostate Cancer Flashcards

1
Q

What are the risk factors for prostate cancer? (5 things)

A
  1. Age
  2. FHx
  3. High testosterone
  4. Black
  5. Obesity
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2
Q

What is the cause of growth in prostate cancer?

A

High androgens (testosterone / dihydrotestosterone)

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3
Q

What is the most common type of prostate cancer?

A

Adenocarcinoma (95%)

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4
Q

Where do prostate adenocarcinomas arise from? (3 things)

A
  1. Peripheral zone (75%)
  2. Transitional zone (20%)
  3. Central zone (5%)
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5
Q

What are the types of prostate adenocarcinoma? (2 things)

A
  1. Acinar adenocarcinoma (most common prostate cancer)
  2. Ductal adenocarcinoma
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6
Q

Where does Acinar adenocarcinoma arise from?

A

Glandular cells lining prostate

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7
Q

Where does Ductal adenocarcinoma arise from?

A

Cells lining duct of prostate gland

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8
Q

Which prostate adenocarcinoma grows + metastasises fastest?

A

Ductal adenocarcinoma

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9
Q

What are the clinical features of prostate cancer? (9 things)

A
  1. LUTS (freq, urgency, weak stream)
  2. Nocturia
  3. Haematuria (adv)
  4. Dysuria (adv)
  5. Incontinence (adv)
  6. Suprapubic pain (adv)
  7. Weight loss (metastasis)
  8. Bone pain (metastasis)

@ DRE (digital rectal examination)
9. Hard + irreg prostate

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10
Q

What are the some differentials that present similarly to prostate cancer? (6 things)

A
  1. BPH (also causes LUTS)
  2. Prostatitis

(also present with haematuria)

  1. Bladder cancer
  2. Urinary stones
  3. UTI
  4. Pyelonephritis
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11
Q

How do you differentiate between Prostatitis and Prostate cancer? (2 things)

A
  1. Prostatitis = perineal pain
  2. Prostatitis = neuts @ urinalysis
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12
Q

What lab test should be done for PSA?

A

PSA (prostate specific antigen test)

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13
Q

What is PSA?

A

Serum antigen produced by malignant AND healthy cells in prostate

RAISED in prostate cancer

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14
Q

How can PSA be raised artificially? (5 things)

A
  1. BPH
  2. Prostatitis
  3. Vigorous exercise (biking)
  4. Ejaculation
  5. Recent DRE
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15
Q

What other tests can you do to increase the accuracy of a PSA test? (2 things)

A
  1. Free:total PSA ratio (low = more likely cancer)
  2. PSA density (high = more likely cancer)
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16
Q

What are other investigations that can be done for prostate cancer? (2 things)

A
  1. Transrectal US
  2. Biopsy
17
Q

Who is staging done for in prostate cancer?

A

Intermediate - High risk disease

18
Q

How is staging done for prostate cancer? (2 things)

A
  1. Abdo-pelvic CT
  2. Bone scan
19
Q

How does prostate cancer spread? (3 things)

A
  1. Locally –> seminal vesicles, bladder, rectum
  2. Lymph
  3. Haematogenously –> sclerotic bony lesions
20
Q

What does the management of prostate cancer depend on?

A

Progression of disease

21
Q

What are the different management schemes for the different levels of prostate cancer?

A
  1. Low risk = active surveillance
  2. Intermediate risk = active surveillance / radical treatment
  3. High risk = radical treatment
  4. Metastatic = chemo + anti-hormonal agents
22
Q

What is done in active surveillance of prostate cancer? (3 things)

A
  1. 3 monthly PSA
  2. 6 monthly DRE
  3. 1-3 yearly re-biopsy
23
Q

What are the Radical treatment options for prostate cancer?

A
  1. Surgery
  2. Radiotherapy
  3. Chemo
24
Q

What is the Radical surgical management of prostate cancer?

A

Radical prostatectomy (open / laparoscopic / robot)

25
Q

What are the side fx of Radical prostatectomy? (3 things)

A
  1. Erectile dysf (60-90%)
  2. Stress incontinence
  3. Bladder neck stenosis
26
Q

What are the types of Radical radiotherapy for prostate cancer? (2 things)

A
  1. External beam radiotherapy
  2. Brachytherapy
27
Q

What are the indications of chemo in prostate cancer?

A

Only for metastasis

28
Q

What are the types of chemo for prostate cancer?

A
  1. Docetaxel (for testosterone resistant cancer)
  2. Cabitaxel (w prednisolone) (for treating relapse after docetaxel not work)

#Phase 2.1: Peri Op (24 decks)

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