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Oncology > Prostate Cancer ♋ > Flashcards

Prostate Cancer ♋ Flashcards

1
Q

What is prostate?

A

Small grand who’s growth controlled by testosterone

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2
Q

Epidemiology

A

Most diagnosed cancer in AUS

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3
Q

Risk Factors for prostate cancer

A

1 age
2 family history
3 genetics
4 ethnicity
5 lifestyle > diet = high fats , red meat, low fruit and veg

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4
Q

Symptoms are rare

What symptoms show in advanced PC

A
  • frequent or sudden need to urinate
  • difficulty urinating
  • blood in urine
  • pain in lower back, pelvis, hips, upper thighs
  • unexplained weight loss
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5
Q

Diagnosis of PROSTATE CANCER

A
  1. Physical exam
  2. Prostate specific antigen
  3. Prostate biopsy = definitive
  4. Gleason score
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6
Q

What is PSA
PROSTATE SPECIFIC ANTIGEN??

A
  1. Produced by both non-malignant and malignant epithelial cells
  2. Prostate specific, not prostate CANCER specific
    May increase from prostatitis and BPH
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7
Q

What is Gleason score?

A

Determines how aggressive the PC will behave.

Higher the number, higher grade of tumor

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8
Q

Radiotherapy
What is Brachytherapy?

A

Implant of radioactive seeds, minimal exposure to surrounding tissues.

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9
Q

Treatment options?

A
  1. Active surveillance
  2. Surgery
  3. Radiotherapy
  4. Hormone therapy or androgen deprivation therapy (ADT)
  5. Chemo
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10
Q

Treatment for ADVANCED PROSTATE CANCER

A
  1. ADT is standard
    Androgen deprivation therapy
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11
Q

What hypothalmic hormone found in PROSTATE CANCER

A

GnRH
Gonadotropin Releasing Hormone

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12
Q

How is testosterone produced in the hypothalmic-pituitary- Endocrine axis?

A
  1. GNRH binds Receptors in pituitary
  2. Increased pituitary hormones = FSH and LH
  3. FSH & LH activate receptors at Endocrine tissues
  4. Get synthesis of TESTOSTERONE
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13
Q

What does GNRH control?

A

Release of Follicle Stimualting Hormone (FSH) and Lutienising Hormone (LH)

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14
Q

In men, what does LH act on?

A

Acts on testicular leydig cells to stimulate de Novo synthesis of androgens (testosterone) from cholesterol

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15
Q

What are the 3 gonadal steroids?

A

Androgens, oestrogen abd progesterone

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16
Q

Name 3 GNRH agonsits

A

Goserelin
Leuprorelin
Triptorelin

17
Q

Name GNRH Antagonist 1

A

Degarelix

18
Q

Name anti androgens
Drug names 2

A

Bicalutamide
Enzalutamide

19
Q

Name a steroid synthesis inhibitor 1

A

Abiraterone
CYP17 inhibitor

20
Q

Action of GNRH agonist?

A

Initially stimulates synthesis of FSH and LH = INCREASING SERUM TESTOSTERONE

continuous administration =

Downregulayes GNRH Receptor = inhibiting gonadotropin production = suppressing testicular steroidogenesis

Causes tumour flare!

21
Q

Action of GNRH Antagonist

A

Competitively and reversibly blocks and ANTAGONISES GNRH receptors

Decreases LH production, which lowers testosterone production in testes.

Lowers testosterone and PSA more quickly.

22
Q

Action of ANTI ANDROGENS

A

Competitively inhibit binding of androgens at the androgen Receptor.

23
Q

Do ANTI ANDROGEN DRUGS disrupt production of androgen?

A

No, only disrupts it’s binding to the Receptor and the down streams Effects of this

24
Q

Indication of use
Anti androgens

A
  • 1st line hormonal therapy
    Add on therapy with orchiectomy or GNRH agonist
  • prevents tumour flares
  • castrate resistant prostate cancer
  • metastatic snd non metastatic pc
25
Q

Steroid synthesis inhibitor

INDICATIONS OF USE

A
  • high risk, resistant advanced prostate cancer
    IN combination with
    PREDNISONE
26
Q

Steroid synthesis inhibitor

action

A

Abitaterone inhibits CYP17, REDUCING synthesis in testicular, adrenal and prostate tumour tissues.

Also lowers other hormones = cortisol

27
Q

Which class of drugs has an

Osteoporosis risk

A

All (GNRH agonist and Antagonist, steroid synthesis inhibitors)

except,
Anti androgens

28
Q

Which drug class causes

Mineralicorticoid effects
(Inc BP, HYPOK, FLUID RETENTION)

A

Steroid synthesis Inhibitors

29
Q

What effect does
ANDROGEN DEPRIVATION THERAPY

Have on bone?

A

ADT reduces serum testosterone concentration =
Increased bone loss and fracture risk

** ensure adequate calcium and vit d

Oncology (15 decks)

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