Prostate Cancer Flashcards

1
Q

What is the most common type of prostate cancer?

A

Adenomacarcinoma

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2
Q

Where is the most common site of prostate cancer?

A

Peripheral zone of the prostate

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3
Q

What genes are associated with prostate cancer?

A

BRCA1 and BRCA2

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4
Q

What are the risk factors for prostate cancer?

A

Increasing age
Family history
Black African or Carribean origin
Tall stature
Anabolic steroids
Obesity

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5
Q

What are the symptoms of prostate cancer?

A

LUTS
- Frequency
- Hesitancy
- Terminal dribbling
- Nocturia
Haematuria
Dysuria
Bone pain (in metastatic disease)
Weight loss
Erectile dysfunction

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6
Q

What are the clinical signs of prostate cancer?

A

Urinary retention
Asymmetrical, hard prostate
Palpable lymphadenopathy (metastatic disease)

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7
Q

What are the common causes of raised PSA?

A

Prostate cancer
BPH
Prostatitis
UTI
Vigorous exercise
Recent ejaculation

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8
Q

What is the main drawback of PSA testing?

A

High rate of false positive and false negative

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9
Q

What findings on prostate exam are suggestive of prostate cancer?

A

Hard, asymmetrical, craggy or irregular prostate
Loss of the central sulcus

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10
Q

What investigations are used in the diagnosis of prostate cancer?

A

PSA
Bone profile (raised ALP and hypercalcaemia - bone mets)
LFTs
U&Es
Multiparametric MRI
Prostate biopsy

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11
Q

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

A

Multiparametric MRI

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12
Q

What is the gold standard investigation of prostate cancer?

A

Prostate biopsy - Transrectal ultrasound guided biopsy or transperineal biopsy

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13
Q

What is the Linkert scale?

A

The Linkert scale is the probability from multiparametric MRI that the patient has prostate cancer
1 - very low suspicion
2 - low suspicion
3 - equivocal
4 - probable cancer
5 - definite cancer

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14
Q

Where does advanced prostate cancer most commonly spread to?

A

Lymph nodes
Bone

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15
Q

What is the Gleason score?

A

Gleason score is used to grade prostate cancer - the two most common type of cells are graded from 1-5 and added together to give a score out of 10
- low grade - <6
- intermediate grade - 7
- high grade - 8-10

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16
Q

What is the TNM staging for prostate cancer?

A

TX - unable to assess size
T1 - to small to be felt on examination or seen on scans
T2 - contained within the prostate
T3 - extends out of the prostate
T4 - spread to nearby organs

NX - unable to assess nodes
N0 - no nodal spread
N1 - spread to lymph nodes

M0 - no metastasis
M1 - metastasis

17
Q

What are the management options for low-intermediate risk prostate cancer?

A

Active surveillance
Radical prostatectomy
Radical radiotherapy or brachytherapy (+/- anti-androgen therapy)

18
Q

What are the management options for high risk localised cancer?

A

Radical prostatectomy
Radical radiotherapy with anti-androgen therapy
Radical radiotherapy with brachytherapy
Docetaxel chemotherapy with anti-androgen therapy