Prostate Cancer

Question 1

What are some factors that can alter PSA levels?

Answer 1

prostate cancer, BPH, prostatitis, trauma, instrumentation, medications

Question 2

does PSA rise with age?

Answer 2

yes, therefore you the same PSA level is MORE significant in younger men than older men and must be adjusted based on age.

Question 3

What are the two markers of prostate cancer?

Answer 3

prostate induration on DRE or elevation of PSA

Question 4

Does prostate cancer have symptoms?

Answer 4

not usually, unless it has metastasized (most often to the bone) or is occluding pee

Question 5

what are some risk factors for prostate cancer?

Answer 5

age > 50, race = african american, environmental exposures, diet of red meats, genetics or family history, obesity, or inflammation of prostate

Question 6

is PSA cancer specific?

Answer 6

no, but it can correlate with stage of disease, monitoring treatment and detecting recurrence of prostate cancer.

Question 7

What is the standard method of detection for prostate cancer?

Answer 7

prostate biopsy. samples are taken on those who have an abnormal PSA or abnormal DRE.

Question 8

What are imaging techniques that can be used for detection of prostate cancer?

Answer 8

transrectal u/s, MRI and radionuclide bone scan.

Question 9

t/f: screening is a universal belief

Answer 9

false, there are many different guidelines out there.

Question 10

What are the current AUA recommendations for screening?

Answer 10

Current AUA recommendations:

1. no screening under 40
2. no routine screening for 40-54 at average risk
3. high risk should be screened after 40
4. 55-69= shared decision making to undergo screening
5. > 70 yo= do NOT screen

Question 11

Where do most cancers arise in the prostate?

Answer 11

in the PERIPHERY!!

Question 12

How are prostate cancers graded?

Answer 12

using the gleason system

Question 13

Is age or life expectancy more important when it comes to treatment of prostate cancers?

Answer 13

life expectancy, it is recommended that treatment is sought after if LE is greater than 10 years. Otherwise, no treatment options are indicated.

Question 14

what is watchful waiting?

Answer 14

it is based on the premise that some patients will not benefit from treatment. early decision to forgo treatment and provide palliative care.

Question 15

Describe the low risk patient and the treatment

Answer 15

PSA <10, gleason score 6 or less, and clinical stage t1 or t2a. Radiation, surgery, or watchful is recommened

Question 16

Describe the intermediate risk patient and the treatment

Answer 16

PSA is 10-20, score is 7, clinical stage is t2b. radiation is recommended and hormone therapy.

Question 17

describe the high risk patient and treatment

Answer 17

PSA >20, score is 8-10, clinical stage it t2c. treatment is radiation and hormone therapy for 2-3 years.