Prostate Cancer Flashcards
What is Prostate Cancer
Adenocaricinoma arising from the the peripheral zones of the prostate.
Incidence of PC
Increases with age.
Most common male malignacy, 80% of men over 80 years old.
Risk Factors of Prostate Ca
Positive family history, high Testosterone levels.
Presentaiton of PC
Nocturia, frequency, uregency, hesitency, incomplete voiding, dysuria, haematuria, poor steam, post void dribbling,
UTI/Renal dysfunction,
Bone pain - mets,
dyspnoea - lung mets
On Examination
Craggy, hard, solid prostate on DRE
Investigations for PC
Bloods - FBC, U+Es, LFTs, Glucose, Calcium, PSA
Imaging for PC
Renal USS - for obstruction
Transurethral Ultrasound/TRUSS plus biopsy.
CXR for lung mets, skeletal survey for bony mets.
CT/MRI for staging.
Bone scan
Staging of PC
Gleason Score
TNM using CT
Bone scan for bony mets
Treatment of PC
Localised disease - Watchful waiting, active surveillance.
Radiotherapy used to reduce size reduce symptoms.
Radical prostectomy - can leave patient incontinent.
TURP if symptomatic
Treatment in Advanced disease
Androgen ablation - LHRH or orchidectomy
Chemoablation
TURP to reduce bulk
Radiotherapy for bone mets.
Complications Prostatic Cancer
Spinal cord compression from spinal local metastasis.
Signs are acute retention, severe pain, unable to walk, constipation.
Urgent MRI needed and spinal decompression.
Ureteric obstruction - nephrostomy of stent insertion before removal of obstruction. Can lead to kidney failure.
