Prostate Cancer Flashcards
what levels of PSA are considered normal
less than 4 = normal
what levels of PSA indicate either prostate cancer or BPH
4-10
a patients prognosis with prostate cancer is dependent on what?
- gleason score
- tumor size
- local extent of primary tumor
what is the primary goal when treating advanced prostate cancer
reduce testosterone levels to castration levels
what are the 3 types of pharmacologic therapy
- androgen deprivation therapy
- chemotherapy
- immunotherapy
what classes of drugs are considered androgen deprivation therapy
luteinizing hormone releasing hormone
gonadotropin releasing hormone
antiandrogens
androgen synthesis inhibitors
what are the LHRH agonists
leuprolide
goserelin
triptorelin
what are the major adverse reactions of LHRH agonists
tumor flare reaction - initial increase in testosterone
decrease in bone mineral density
what is a GnRH antagonist
degarelix (Firmagon)
what are the antiandrogen drugs
flutamide
bicalutamide
nilutamide
what is the indication for antiandrogens
metastatic prostate cancer and MUST be given in combination with LHRH agonists
what is prostate tumor cells that have acquired the ability to survive and proliferate with castration levels of testosterone
castration-resistant prostate cancer (CRPC)
what is the first line therapy for castration-resistant prostate cancer (CRPC) that has spread to organs
enzalutamide
docetaxel
what is the first line therapy for castration-resistant prostate cancer (CRPC) that has not spread to organs or bones (different from if it has spread to organs)
abiraterone
what is an immunotherapy option for CRPC who meet the criteria
sipuleucel-T
