prostate cancer Flashcards
most commonly spreads to
lymph nodes
bones
most common histological type
adenocarcinoma
peripheral zone of prostate
risk factors
age FHx black african or carribean origin tall stature anabolic steroids
presentation
LUTs asymptomatic haematuria erectile dysfunction Sx of advanced disease/metastasis: weight loss, bone pain
prostate - specific antigen
produced by epithelial cells of prostate
glycoprotein secreted in semen
causes of raised PSA
prostate cancer
BPH
UTI
prostatitis
multiparametric MRI
first line investigation
multiparametric MRI : likert scale 1
very low suscpision
multiparametric MRI : likert scale 2
low suspicion
multiparametric MRI : likert scale 3
equivocal
multiparametric MRI : likert scale 4
probable cancer
multiparametric MRI : likert scale 5
definite cancer
prostate biopsy: when to do one
decision to perform depends on MRI findings (Linkert 3+) and clinical suspicion (examination + PSA level)
2 options for prostate biopsy
transrectal USS guided biopsy
transperineal biopsy
risks of prostate biopsy
pain bleeding infection urinary retention erectile dysfunction
Gleason grading system
based on histology from biopsy
determines treatment
greater the score, the more poorly differentiated the tumour is and the worse the prognosis is
how are gleason scores calculated
made up of 2 numbers added together to give final score
- grade of most prevalent pattern in biopsy
- grade of second most prevalent pattern in biopsy
gleason score - 6
low risk
gleason score - 7
intermediate risk
3+4 is lower risk than 4+3
gleason score - 8+
high risk
TNM staging: TX
unable to assess sise
TNM staging: T1
too small to be felt on examination or seen on scans
TNM staging: T2
contianed within prostate
TNM staging: T3
extends out of prostate
