prostate cancer Flashcards
give tx option for low-risk pt with prostate cancer
active surveillance - monitoring of PSA levels until changes require radical intervention
name 4 radical tx approaches for intermediate risk prostate cancer
Radical prostatectomy - achievable if confined to prostate and is the removal of whole prostate +/- Svs and adjacent bladder neck - positive margin requires post-op RT and toxicities = urinary incon. and erectile dysfunction.
EBRT - hypofrctionated 60Gy 20# 4 weeks - prostate only +/- Svs with convention 78gy in 39# for unfit or 74Gy in 37# for prostate + LNs. - all cause bowel and bladder toxicities
Brachytherapy - HDR needles of 15Gy Boost followed by 37.5Gy in 15# EBRT or LDR permanent brachy seeds
ADT - prohibits testosterone and is a good primary tx for frail/elderly but also used neoadjuvantly to de-bulk or adjuvantly for improved prognosis
name 5 tx options for high risk prostate opts
RP
EBRT
BT
ADT
chemotherapy - Docetaxel
palliate tx for hormone naive prostate cancer
orchidectomy - removal of testicals
chemotherapy - docetaxel
give TNM staging for prostate cancer
t1= too small to be seen or palpitated
t2= contained within prostate
t3a=only broken through capsule
t3b=invaded Svs
t4=metastatic spread
give 5 etiological risk factors for prostate cancer
age - older
genetic history
race - black men inc. risk
obesity
diet
Gleason score for prostate cancer
2-4 well diff.
5-7 moderately diff.
8-10 poorly differentiated
most common tumour cell type for prostate cancer
adenocarcinoma
what is the PACE-B trial for
prosate cancer
identifies if SBRT is non-inferior to hypo fractionated and conventional RT = found 5# SBRT to be non-inferior and to become standard of care
what is HERMES trial for
prostate cancer
whether <5# SBRT can be delivered on an MR linac = 24Gy in 2 # over 8 days - ongoing study
spread for prostate cancer
local = nearby organs
lymph= para-aortic
blood= bones / vertebrae
palliative EBRT for prostate cancer
30Gy in 10# over 2 weeks //opp whole pelvis
