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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?

25
What are the 3 Androgen Ablation agonists?
1. Leuprolide 2.Goserelin 3. Triptorelin
26
What are 6 ADRS of Androgen ablation therapy?
1. Hot flashes 2. Erectile impotence 3. Decreased libido 4. Metabolic Complications 5. CVD 6. Osteoporosis
27
What is the most commonly used antiandrogen?
Bicalutamide
28
Bicalutamide
CASODEX
29
Goserelin
ZOLADEX
30
Hormone refractory occurs when the serum testosterone is what?
< 50
31
Abiraterone
Zytiga
32
What should zytiga be used with?
Prednisone
33
What does zytiga selectively and irreversibly inhibit?
Cyp17
34
What is a complication with zytiga?
Interacts with most drugs
35
How should you take Abiraterone?
On an empty stomach
36
What’s are the 4 first line agents for hormone refractory?
1. Abiraterone 2. Androgen R inhibitors 3. Relugolix 4. Docetaxel
37
What 3 things do androgen R inhibitors do?
1. Inhibits androgens from binding to the receptor 2. Inhibits androgen R from entering the cell nucleus 3. Inhibits androgen R binding
38
What are the 3 Androgen R inhibitors?
1. Enzalutamide 2. Apalutamide 3. Darolutamide
39
Enzalutamide
XTANDI
40
Apalutamide
ERLEADA
41
Darolutamide
NUBEQA
42
Do androgen R inhibitors require concurrent use with prednisone?
No
43
What is zytiga considered as?
An antiandrogen
44
WHAT DOES DOCETAXEL INHIBIT?
Depolymerization of tubulin
45
Docetaxel
TAXOTERE
46
What is the regimen for stage 4 Pc?
1. ADT 2. Secondary hormonal therapy 3. Chemotherapy
47
What two drugs are used to prevent skeletal related events?
1. Zoledronic acid 2. Denosumab
48
Zoledronic Acid
Zometa
49
Denosumab
XGEVA
50
Triptorelin
TRELSTAR

PY3 (24 decks)

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