Prostate Cancer

Question 1

Epidemiology

Prostate

Answer 1

Most common cancer in males.
65 years and older.
African American.

Question 2

Prognostic factors

Prostate

Answer 2

Stage
Grade
PSA level
LN status

Question 3

LN drainage

Prostate

Answer 3

Periprostatic and obturaror
External iliac
Internal iliac
Common iliac
Periaortic

Question 4

Clin. Pres.

Prostate

Answer 4

Decreased urinary stream
Frequency
Difficulty starting urination
Dysuria
Hematuria

Question 5

When should PSA and DRE
screening start
Prostate

Answer 5

Older than 50

Question 6

Normal PSA level

Answer 6

< 4 ng/ml

Question 7

Pathology

Prostate

Answer 7

Adenocarcinoma

Question 8

Observation as tmt for

Prostate

Answer 8

Older than 75.

65-75 with small well-differentiated.

Question 9

Tmt for T1 or T2

Prostate

Answer 9

Prostatectomy

Question 10

Tmt for T3

Prostate

Answer 10

EBRT with hormone therapy

Question 11

Hormone therapy options

Prostate

Answer 11

Orchiectomy
Estrogen
Gonadotropin-releasing hormone agonists (Zoladex, Lupron).
Nonsteroidal antiandrogens (Eulexin, Casodex).

Question 12

Metastatic pt Tmt

Prostate

Answer 12

Docetaxel plus prednisone when HT is no longer effective.

Question 13

Dose to pelvic LN

Prostate

Answer 13

45-50Gy

Question 14

Dose to seminal vesicles

Answer 14

54-56Gy

Question 15

Dose to prostate

Answer 15

72-80Gy (1.8-2Gy/day)

Question 16

Dose to prostate bed

Answer 16

64-66Gy

Question 17

Surgery SE

Prostate

Answer 17

Incontinence

Sexual impotence

Question 18

Acute Rx SE

Prostate

Answer 18

Diarrhea
Abdominal cramping
Rectal discomfort
Rectal bleeding

Question 19

Late Rx SE

Prostate

Answer 19

Persistent proctitis
Rectal bleeding
Ulceration
Sexual impotence

Question 20

Where is the prostate located?

Answer 20

Inf to urinary bladder and ant to rectum