Prostate Cancer Flashcards
Risk factors of prostate cancer
Increasing age
Family history
BRCA2 gene mutation
Ethnicity - black people + Asians
What zone of the prostate are prostate cancers most commonly found?
peripheral zone
Presentation of prostate cancer
- Symptoms of UTI
- bone pain due to prostatism or metastatic disease in bone (often spine)
- raised PSA
Prostate cancer in digital rectal exam
Hard
Irregular
Causes of raised prostate specific antigen
Prostate cancer
Infection
Inflammation
Large prostate
Urinary retention
Staging of prostate cancer
TNM staging
Should a prostate specific antigen test be done before or after a digital rectal exam?
PSA before DRE
DRE can cause elevated PSA
Histological grading of prostate cancer
Gleason classification
Diagnosis of prostate cancer
- hard + irregular prostate on DRE
- biopsy
- ultrasound
- increased PSA
- radiographs + bone scans to stage + identify metastatic spread
What can patients with advanced prostate cancer develop?
Sclerotic bone legions
Treatment of localised prostate cancer
Depends on stage on tumour
- surgery - prostatectomy
- hormone therapy
- radiotherapy if unfit for surgery
- surveillance
Side effects of radiotherapy
- discomfort around radiotherapy site
- diarrhoea
- loss of pubic hair
- tiredness
- inflammation of bladder lining
- erectile dysfunction
Side effects of prostatectomy
Urinary Incontience
Erectile dysfunction
Infertility
What are the emerging treatments of prostate cancer?
- Brachytherapy: radiation dose delivered inside prostate gland
- High intensity focused ultrasound: uses US waves to destroy cancerous prostate tissue
- Cryotherapy: cryoneedles inserted into prostate gland through rectum > freeze prostate gland
Treatment of advanced prostate cancer
- hormone manipulation: testosterone promotes tumour growth
- surgical castration
- medical castration (LHRH, GnRH agonist)
- palliative care
