Prostate cancer

Question 1

What is the histology of prostate cancer?

Answer 1

adenocarcinoma

Question 2

Which area of the prostate does prostate cancer predominantly affect?

Answer 2

peripheral zone of prostate

Question 3

Three features of clinical presentation of prostate cancer?

Answer 3

usually asymptomatic
nocturia, frequency, hesitancy, poor stream, obstruction, terminal dribbling
weight loss, fatigue
Mets- bone pain

Question 4

How can you distinguish between prostate cancer and BPH on examination?

Answer 4

Cancer- hard, irregular vs BPH- smooth and regular

Cancer- loss of midline sulcus

Question 5

Three modes of spread of prostate cancer?

Answer 5

local
haematological
lymph

Question 6

Two imaging investigations for prostate cancer?

Answer 6

Transrectal US + biopsy
Bone scane
Staging MRI
XR chest and spine

Question 7

Name three conditions in which PSA is raised

Answer 7

increasing age
TURP
prostatitis
cancer
PR exam

Question 8

Three management options for prostate cancer

Answer 8

Radical therapy: radical prostatectomy

Medical: LHRH analogues, anti-androgens

Symptomatic: TURP for obstruction, analgesia, radiotherapy for bone mets

Conservative: active monitoring

Question 9

Which scoring system is used to grade prostate cancer?

Answer 9

Gleason grading system