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urology > prostate cancer > Flashcards

prostate cancer Flashcards

1
Q

most commonly spreads to

A

lymph nodes

bones

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2
Q

most common histological type

A

adenocarcinoma

peripheral zone of prostate

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3
Q

risk factors

A 
age 
FHx
black african or carribean origin 
tall stature
anabolic steroids
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4
Q

presentation

A 
LUTs
asymptomatic 
haematuria 
erectile dysfunction 
Sx of advanced disease/metastasis: weight loss, bone pain
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5
Q

prostate - specific antigen

A

produced by epithelial cells of prostate

glycoprotein secreted in semen

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6
Q

causes of raised PSA

A

prostate cancer
BPH
UTI
prostatitis

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7
Q

multiparametric MRI

A

first line investigation

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8
Q

multiparametric MRI : likert scale 1

A

very low suscpision

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9
Q

multiparametric MRI : likert scale 2

A

low suspicion

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10
Q

multiparametric MRI : likert scale 3

A

equivocal

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11
Q

multiparametric MRI : likert scale 4

A

probable cancer

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12
Q

multiparametric MRI : likert scale 5

A

definite cancer

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13
Q

prostate biopsy: when to do one

A

decision to perform depends on MRI findings (Linkert 3+) and clinical suspicion (examination + PSA level)

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14
Q

2 options for prostate biopsy

A

transrectal USS guided biopsy

transperineal biopsy

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15
Q

risks of prostate biopsy

A 
pain 
bleeding 
infection 
urinary retention 
erectile dysfunction
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16
Q

Gleason grading system

A

based on histology from biopsy
determines treatment

greater the score, the more poorly differentiated the tumour is and the worse the prognosis is

17
Q

how are gleason scores calculated

A

made up of 2 numbers added together to give final score

  1. grade of most prevalent pattern in biopsy
  2. grade of second most prevalent pattern in biopsy
18
Q

gleason score - 6

A

low risk

19
Q

gleason score - 7

A

intermediate risk

3+4 is lower risk than 4+3

20
Q

gleason score - 8+

A

high risk

21
Q

TNM staging: TX

A

unable to assess sise

22
Q

TNM staging: T1

A

too small to be felt on examination or seen on scans

23
Q

TNM staging: T2

A

contianed within prostate

24
Q

TNM staging: T3

A

extends out of prostate

25
Q

TNM staging: T4

A

spread to nearby organs

26
Q

TNM staging: NX

A

unable to assess nodes

27
Q

TNM staging: N0

A

no nodal spread

28
Q

TNM staging: N1

A

spread to lymph nodes

29
Q

TNM staging: M0

A

no metastasis

30
Q

TNM staging: M1

A

metastasis

31
Q

Mx options

A 
watchful waiting
external beam radiotherapy 
brachytherapy 
hormonetherapy 
surgery
32
Q

key complication of external beam radiotherapy

A

proctitis

33
Q

what is brachytherapy

A

radioactive metal seeds are implanted into prostate

deliver continuous targeted radiotherapy to prostate

34
Q

hormone therapy mechanism

A

aims to reduce level of androgens that stimulate cancer growth

35
Q

side effects of hormone therapy

A 
hot flushes
sexual dysfunction 
gynaecomastia 
fatigue 
osteoporosis
36
Q

surgical

A

radical prostatectomy

37
Q

radical prostatectomy complications

A

erectile dysfunction

urinary incontinence

urology (17 decks)

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