Prostate cancer Flashcards
Which part of the prostate is most commonly affected in prostate cancer?
Peripheral zone
What is the most common cancer in men?
Prostate cancer
How does prostate cancer feel on a DRE?
Firm hard asymmetrical irregular lumpy Loss of the central sulcus.
What are some risk factors for prostate cancer?
Older age Family history Black african or Caribbean origin Anabolic steroids Smoking
What are the symptoms of prostate cancer?
Most are asymptomatic.
May have LUTS - e.g. hesitancy, increased frequency, weak flow, terminal dribbling and nocturia.
Haematuria
Erectile dysfunction
Symptoms of metastasis - weight loss, bone pain etc.
How is suspected prostate cancer investigated?
DRE PSA (unreliable) Multiparametric MRI Prostate biopsy Isotope Bone scan can also be used to look for bony metastises
What are the risks of a prostate biopsy?
False negatives if the biopsy misses the cancerous area.
Pain
Bleeding
Infection
Urinary retention due to short term swelling
Erectile dysfunction (rare)
What are the two methods for a prostate biopsy?
Transrectal ultrasound guided biopsy
Transperineal biopsy
What staging systems can be used to assess severity of prostate cancer?
Gleason grading system
TNM staging
What is the gleason grading system for prostate cancer based on?
Histology from biopsies.
The higher the score the more poorly differentiated hence worse prognosis.
How is prostate cancer managed?
Surveillance - if early as normally slow growing External beam radiotherapy Brachytherapy (internal radiotherapy) Hormone therapy Surgery
What is brachytherapy?
A type of internal radiotherapy
What are side effects of brachytherapy for prostate cancer?
Inflammation in nearby organs - cystitis (bladder) or proctitis (rectum).
Can also lead to ED, incontinence and increased risk of bladder or rectal cancers.
What is a complication of external beam radiotherapy for prostate cancer?
Proctitis - inflammation of the rectum
- Causing pain, altered bowel habits, bleeding and discharge.
What are the different hormone therapies that can be given for prostate cancer?
Androgen receptor blocks
GnRH agonists
Bilateral orchidectomy to remove testicles
