Prostate Cancer Flashcards
Where is the base of the prostate?
Continuous to bladder neck
Superior
What is the inferior portion of the prostate called?
Apex
What cells cover the prostatic urethra?
Transitional epithelium
What is the verumotanum?
Ejaculatory ducts enter here
What are the three zones of the prostate?
Transitional zone
Central zone
Peripheral zone
What common pathology occurs in the transitional zone?
Benign prostatic hypertrophy
Where is the central zone?
Surround the ejaculatory ducts
What can form in the peripheral zone of the prostate?
Adenocarcinoma
What is the peak age for prostate cancer?
70+
True or False
There is no genetic link with prostate cancer
False.
Having a first degree relative with prostate Ca doubles the risk
What is the presentation of prostate cancer?
Haematuria
Haematospermia
LUTS
What highly sensitive but poorly specific test can be done for prostate cancer?
PSA
What is the danger of using PSA as a prostate cancer marker?
Also raised if been instrumented or in infection or after DRE
What may be observed on DRE in prostate cancer?
Asymmetrical craggy mass
What must occur when testing a patient’s PSA?
Must be before a DRE
Must counsel patient as to results
What is the next step with a positive PSA and abnormal DRE?
Trans-rectal USS guided prostate biopsy
What is the main type of prostate cancer?
Adenocarcinoma
Where does prostate cancer metastasise to?
Bone
What is characteristic of prostate cancer on x-ray?
Sclerotic lesions on bone
What grading score is done for prostate cancer?
Gleason’s scoring
1-5
What are the treatment options for prostate cancer?
Watch and wait
Radical surgery
Radical radiotherapy
Androgen deprivation drugs
True or False
Patient will definitely have ED after radical surgery
False.
Half of patients have ED
True or False
Most of the body’s testosterone comes from the testis
True
Why does androgen deprivation work as a therapy?
If androgens are suppressed for long enough prostate cells die without them
How do LHRH agonists work?
Downregulate LHRH receptors so suppress LH and FSH to reduce testosterone production
What are the side effects of LHRH agonists?
ED Loss of libido Weight gain Gynaecomastia Osteoporosis
What is testosterone surge?
Transient rise in LH/FSH which causes testosterone production in first few weeks of LHRH agonist therapy
How are LHRH agonists given?
Tablets
Injection
Implant
How is testosterone surge avoided?
Anti-Androgen cover given for 1 week before LHRH injection
How do anti-androgens work?
Compete with testosterone for binding sites, inhibiting prostate Ca growth.
What are the two types of anti-androgens?
Steroidal
Non-steroidal
Which anti-androgen type is preferable for younger or more sexually active men?
Non-steroidal as this maintains libido
