Prostate Cancer Flashcards
What is the most common type of prostate cancer?
Adenomacarcinoma
Where is the most common site of prostate cancer?
Peripheral zone of the prostate
What genes are associated with prostate cancer?
BRCA1 and BRCA2
What are the risk factors for prostate cancer?
Increasing age
Family history
Black African or Carribean origin
Tall stature
Anabolic steroids
Obesity
What are the symptoms of prostate cancer?
LUTS
- Frequency
- Hesitancy
- Terminal dribbling
- Nocturia
Haematuria
Dysuria
Bone pain (in metastatic disease)
Weight loss
Erectile dysfunction
What are the clinical signs of prostate cancer?
Urinary retention
Asymmetrical, hard prostate
Palpable lymphadenopathy (metastatic disease)
What are the common causes of raised PSA?
Prostate cancer
BPH
Prostatitis
UTI
Vigorous exercise
Recent ejaculation
What is the main drawback of PSA testing?
High rate of false positive and false negative
What findings on prostate exam are suggestive of prostate cancer?
Hard, asymmetrical, craggy or irregular prostate
Loss of the central sulcus
What investigations are used in the diagnosis of prostate cancer?
PSA
Bone profile (raised ALP and hypercalcaemia - bone mets)
LFTs
U&Es
Multiparametric MRI
Prostate biopsy
What is the first-line investigation for suspected localised prostate cancer?
Multiparametric MRI
What is the gold standard investigation of prostate cancer?
Prostate biopsy - Transrectal ultrasound guided biopsy or transperineal biopsy
What is the Linkert scale?
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
Where does advanced prostate cancer most commonly spread to?
Lymph nodes
Bone
What is the Gleason score?
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
What is the TNM staging for prostate cancer?
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
What are the management options for low-intermediate risk prostate cancer?
Active surveillance
Radical prostatectomy
Radical radiotherapy or brachytherapy (+/- anti-androgen therapy)
What are the management options for high risk localised cancer?
Radical prostatectomy
Radical radiotherapy with anti-androgen therapy
Radical radiotherapy with brachytherapy
Docetaxel chemotherapy with anti-androgen therapy
