prostate cancer Flashcards
should you routinely test for PSA?
NO. it does not lower mortality rate and does not improve a patient’s quality of life.
Why does finasteride or dutasteride not lower mortality or prevent metastatic disease in prostate CA?
They only work on small cancers and have no effect on large cancers which have a propensity to metastases
MOA of finasteride or dutasteride?
blocks 5a-reductase, thus blocking DHT production
DHT: promotes prostate tissue growth
useless in prostate CA, but treats BPH
Initial W/U for prostate CA in case of an enlarged prostate with nodule?
PSA and prostate biopsy
what scoring system indicates the likelihood of metastasis?
Gleason scoring on pathology
If there prostate CA with bone metastasis & active symptoms of spinal cord compression, what will you do FIRST?
IV steroids eg. dexamethasone
- decrease the swelling and cord compression
What is the further treatment for prostate CA with bone metastases?
Radiation therapy + flutamide followed by finasteride
what is the fastest way to decrease androgen levels?
orchiectomy
MOA of goserelin or leuprolide?
GnRH agonists
- cause continuous endogeneous hormone production
- leads to downregulation of GnRH receptors at the pituitary gland eventually decreasing LH and FSH production
MOA of flutamide or bicalutamide?
testosterone receptor antagonists
MOA of abiraterone
inhibitor of 17a-OH in the gonads and adrenals thus shitting off produciton of DHEAS (precursor to testosterone)
MOA of degarelix
a GnRH receptor antagonist
