Prostate cancer Flashcards
Epi of prostate cancer
Most common male cancer
Spread of prostate cancer
- lymph nodes
- bones
Prostate cancer is dependent on
Androgen
Ethnicity RF for prostate cancer
Black African/Caribbean
Medication RF for prostate cancer
Anabolic steroids
Other RFs for prostate cancer
- tall stature
- FH
- age
If symptomatic what are the symptoms of prostate cancer
- LUTI
- haematuria
- erectile dysfunction
- symptoms of metastasis
Source of PSA
Epithelial cells
Why is PSA unreliable
- false +ve
- false -ve
Describe findings of benign prostate upon prostate examination
- smooth
- slightly soft
- maintained central sulcus
Describe findings of prostatic hyperplasia upon prostate examination
Generalised enlargement
Describe findings of prostatitis upon prostate examination
- enlarged
- tender
- warm
Describe findings of cancerous prostate upon prostate examination
- firm/hand
- asymmetrical
- craggy/irregular
- hard nodule
1st line Ix for prostate cancer
Multiparametric MRI
Likert scale used in what Ix
Multiparametric MRI
Likert scale 1-5
1 - very low suspicion 2 - low suspicion 3 - equivocal 4 - probable cancer 5 - definite cancer
2nd line Ix for prostate cancer
Prostate biopsy
Disadvantages of biopsy
- risk of false -ve
- pain
- bleeding
- infection
- urinary retention
- erectile dysfunction
When to use isotope bone scan
Look for metastasis
Gleason grading system two-number interpretation
1st —> most prevalent pattern in biopsy
2nd —> second most prevalent pattern
Gleason of 6, 7, 8
6 —> low risk
7 —> intermediate
8&> —> + risk
General rule of Gleason grading system
++ number —> ++ poorly differentiated
Staging system of prostate cancer
TNM
Radiation is associated with the risk of
Association
Mx of prostate cancer
- surveillance
- external beam radiotherapy
- brachytherapy
- hormone therapy
- surgery
Purpose of hormone therapy
— androgen levels
Example of androgen receptor blockers
Bicalutamide
GnRH agonists
- goserellin
- leuprotein
