Prostate Cancer

Question 1

What are the SSx of prostate cancer?

Answer 1

Localised disease:

• Problems urinating
• Poor stream of urine
• Blood in semen
• Blood in urine
• Erectile dysfunction
• Discomfort in the pelvic area
• Abdominal distention

Advanced stage:

• Bone pain
• Back pain

Question 2

Imaging modality for suspected prostate cancer?

Answer 2

MRI

Question 3

1st line investigations for prostate cancer?

Answer 3

DRE and urine dipstick (to look for blood)

Question 4

What blood test for prostate cancer?

Answer 4

PSA

although raised in prostatitis, BPH

Question 5

What are some risk factors for prostate cancer? Give me modifiable and non-modifiable risk factors.

Answer 5

Modifiable:
Obesity
Smoking
Diet

Non-modifiable:
African ethnicity
BRCA mutation
Family history
Increasing age

Question 6

Treatment for prostate cancer?

Answer 6

Active surveillance - for low grade well patients
Radiotherapy - palliative or curative (for mets)
Locally advanced/Metastatic –> Hormonal therapy i.e Goserelin, Degarelix, Bicalutamide
Surgical resection i.e laparoscopic prostatectomy

Question 7

What might you feel on DRE in prostate cancer patients?

Answer 7

Hard, irregularly shaped prostate
Lack of median sulcus
Asymmetrical prostate