Prostate Cancer Flashcards

1
Q

Median age of diagnosis for prostate cancer

A

72 years old

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2
Q

What are 7 risk factors of prostate cancer?

A
  1. Age
  2. Sex
  3. Race
  4. Family History
  5. BPH
  6. Increased testosterone exposure
  7. Diet
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3
Q

Why should you not use the 5-alpha reductive inhibitors?

A

Patients can develop a more aggressive form

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4
Q

What are the 3 screening techniques used?

A
  1. Digital rectal exam (DRE)
  2. Prostate specific antigen (PSA)
  3. Transrectal ultrasonography
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5
Q

Glycoprotein produced by prostate epithelial cells

A

Prostate specific antigen

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6
Q

Higher levels of PSA = ?

A

Increased risk of prostate cancer

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7
Q

All men >50 should be offered to take what two tests?

A
  1. PSA
  2. DRE
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8
Q

If a patients life expectancy is <10 years, should they be screening for prostate cancer?

A

No

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9
Q

Early stages/ localized disease is __________.

A

Asymptomatic

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10
Q

Since prostate cancer is an advanced metastatic disease, what 5 things does it cause?

A
  1. Lower extremity edema
  2. Hematuria or blood in the semen
  3. Bone fracture pain/fractures
  4. Anemia
  5. Weight loss
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11
Q

What are 3 metastatic sites for prostate cancer?

A
  1. Bone
  2. Lung
  3. Liver
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12
Q

Test that determines the aggressiveness of PC

A

Gleason Score

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13
Q

What is the worst prognosis you can get for the Gleason score?

A

10

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14
Q

What stages of PC are confined to the prostate?

A

T1 and T2

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15
Q

What are the options for treatment in localized pc?

A
  1. Active surveillance
  2. Radical prostatectomy
  3. Radiation Therapy
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16
Q

What is premise for active surveillance?

A

That PC is benign and indolent

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17
Q

When is active surveillance the most appropriate? 2

A
  1. < 10 years of life expectancy
  2. Low grade disease
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18
Q

What are two complications pc patients face with radiation?

A
  1. Impotence
  2. Rectal/bladder symptoms
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19
Q

What are your options for stage 3 pc?

A
  1. Radiation +/- ADT
  2. ADT
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20
Q

What are the 2 first line hormonal therapies?

A
  1. Androgen Ablation
  2. Combined androgen blockade
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21
Q

What is combined androgen blockade?

A

LHRH agonist + antiandrogen

22
Q

What is the MOA for androgen ablation therapy?

A

Surge of LHRH leading to increased production of LH and ACTH

23
Q

What are 2 limitations to Androgen Ablation therapy?

A
  1. Disease Flare
  2. Expensive
24
Q

How long would you add an antiandrogen to suppress an LH/ACTH flare?

A

7 days

25
Q

What are the 3 Androgen Ablation agonists?

A
  1. Leuprolide
    2.Goserelin
  2. Triptorelin
26
Q

What are 6 ADRS of Androgen ablation therapy?

A
  1. Hot flashes
  2. Erectile impotence
  3. Decreased libido
  4. Metabolic Complications
  5. CVD
  6. Osteoporosis
27
Q

What is the most commonly used antiandrogen?

A

Bicalutamide

28
Q

Bicalutamide

A

CASODEX

29
Q

Goserelin

A

ZOLADEX

30
Q

Hormone refractory occurs when the serum testosterone is what?

A

< 50

31
Q

Abiraterone

A

Zytiga

32
Q

What should zytiga be used with?

A

Prednisone

33
Q

What does zytiga selectively and irreversibly inhibit?

A

Cyp17

34
Q

What is a complication with zytiga?

A

Interacts with most drugs

35
Q

How should you take Abiraterone?

A

On an empty stomach

36
Q

What’s are the 4 first line agents for hormone refractory?

A
  1. Abiraterone
  2. Androgen R inhibitors
  3. Relugolix
  4. Docetaxel
37
Q

What 3 things do androgen R inhibitors do?

A
  1. Inhibits androgens from binding to the receptor
  2. Inhibits androgen R from entering the cell nucleus
  3. Inhibits androgen R binding
38
Q

What are the 3 Androgen R inhibitors?

A
  1. Enzalutamide
  2. Apalutamide
  3. Darolutamide
39
Q

Enzalutamide

A

XTANDI

40
Q

Apalutamide

A

ERLEADA

41
Q

Darolutamide

A

NUBEQA

42
Q

Do androgen R inhibitors require concurrent use with prednisone?

A

No

43
Q

What is zytiga considered as?

A

An antiandrogen

44
Q

WHAT DOES DOCETAXEL INHIBIT?

A

Depolymerization of tubulin

45
Q

Docetaxel

A

TAXOTERE

46
Q

What is the regimen for stage 4 Pc?

A
  1. ADT
  2. Secondary hormonal therapy
  3. Chemotherapy
47
Q

What two drugs are used to prevent skeletal related events?

A
  1. Zoledronic acid
  2. Denosumab
48
Q

Zoledronic Acid

A

Zometa

49
Q

Denosumab

A

XGEVA

50
Q

Triptorelin

A

TRELSTAR