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2a Genitourinary > Prostate cancer > Flashcards

Prostate cancer Flashcards

1
Q

True or false: prostate cancer is the most common cancer in men

A

True

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2
Q

Advanced prostate cancer most commonly spreads to the ______ ____ and ____

A

lymph nodes and bones (thick sclerotic lesions)
Also to liver, lung and brain

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3
Q

Prostate cancer is almost always a_____-dependent as they rely on a_____ hormones to grow

A

androgen

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4
Q

The majority of prostate cancers are __________ (type of cancer) and grow in the peripheral zone of the prostate

A

adenocarcinomas

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5
Q

What are risk factors for prostate cancer

A

Age
Family history
Black African or Caribbean origin
Tall stature
Anabolic steroids

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6
Q

What genes are associated with prostate cancer?

A

BRCA2 and HOXB13

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7
Q

Prostate cancer may be asymptomatic or may present with lower _____ ___ symptoms like benign prostate hyperplasia

A

urinary tract

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8
Q

What are some lower urinary tract symptoms?

A

Hesitancy
Frequency
Weak flow
Terminal dribbling
Nocturia

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9
Q

What are some other non-lower urinary tract symptoms of prostate cancer?

A

Haematuria
Erectile dysfunction

Symptoms of advanced disease / metastasis:
weight loss
Bone pain
Cauda equina syndrome

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10
Q

Epithelial cells of the prostate release p____-s____ a_____ which is a glycoprotein.

A

prostate-specific antigen (PSA)

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11
Q

PSA is secreted in the _____ with small amount entering the blood

A

semen

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12
Q

True of false: PSA’s enzymatic activity helps to thicken the semen after ejaculation

A

False
It helps to thin the thick semen into a liquid consistency after ejaculation

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13
Q

True or false: a raised level of PSA can indicate potential prostate cancer

A

True

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14
Q

Is PSA testing reliable for screening?

A

Has a high rate of false positives (75%) and false negatives (15%)

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15
Q

What else can cause raised PSA levels?

A

Benign prostatic hyperplasia
Prostatitis
UTIs
Vigorous exercise, especially cycling
Reject ejaculation or prostate stimulation

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16
Q

A prostate exam is performed during a d___ r___ examination

A

digital rectal

17
Q

How does a benign prostate feel?

A

Smooth, symmetrical and slightly soft with a maintained central sulcus (dip between the 2 lobes).

In hyperplasia, may be generalised enlargement.

18
Q

How may an infected of inflamed prostate feel?

A

May be enlarged, tender and warm

19
Q

How may a cancerous prostate feel?

A

Firm or hard and asymmetrical, craggy or irregular.
Loss of central sulcus
Possible hard nodule

20
Q

What are the next steps after finding a potential prostate cancer from an examination?

A

2 week wait referral to urology

21
Q

What is the first line investigation for suspected localised prostate cancer?

A

Multiparametric MRI

22
Q

What is the Likert scale?

A

Scale 1-5 to rate how likely it is a cancer
1 = very low suspicion
5 = definite cancer

23
Q

After taking a multiparametric MRI, what is the next stage in investigation?

A

Prostate biopsy (however risk of false-negative if biopsy misses cancerous area)

24
Q

What are the 2 options for prostate biopsy?

A

Transrectal ultrasound-guided biopsy (TURS, through rectum into prostate)
or
Transperineal biopsy (through skin behind testicles)

25
Q

What are the main risks of a prostate biopsy?

A

Pain
Bleeding (stools, urine or semen)
Infection
Urinary retention (due to short term swelling of prostate)
Erectile dysfunction

26
Q

What imaging can be used to look for bony metastasis?

A

An isotope bone scan (also called radionuclide scan)

27
Q

How does an isotope bone scan work?

A

IV injection of radioactive isotope
Wait 2-3 hours
Bone takes up isotope
metastatic bone lesions take up more of isotope
Gamma camera takes picture of skeleton
Lesions stand out more on scan

28
Q

What grading system is used from the prostate biopsies and is used to determine treatment?

A

Gleason grading system (2 number added together for total score)

29
Q

What do the 2 numbers of the Gleason score indicate?

A

First number is the grade of the most prevalent pattern in the biopsy

Second number is grade of second most prevalent pattern in biopsy

Score of:
6 = low risk
7 = intermediate risk
8+ = high risk

30
Q

What treatment is available for prostate cancer?

A

Surveillance in early stage

External beam radiotherapy
Brachytherapy
Hormone therapy
Surgery

31
Q

What is a complication of external beam radiotherapy?

A

Proctitis, inflammation in the rectum causing pain, altered bowel habit or rectal bleeding and discharge

32
Q

What is brachytherapy?

A

Implanting radioactive metal “seeds” into the prostate to deliver continuous targeted radiotherapy

33
Q

True or false: prostate cancer is the most hormone sensitive cancer

A

True

2a Genitourinary (28 decks)

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