Prostate Cancer

Question 1

Where is the base of the prostate?

Answer 1

Continuous to bladder neck

Superior

Question 2

What is the inferior portion of the prostate called?

Answer 2

Apex

Question 3

What cells cover the prostatic urethra?

Answer 3

Transitional epithelium

Question 4

What is the verumotanum?

Answer 4

Ejaculatory ducts enter here

Question 5

What are the three zones of the prostate?

Answer 5

Transitional zone
Central zone
Peripheral zone

Question 6

What common pathology occurs in the transitional zone?

Answer 6

Benign prostatic hypertrophy

Question 7

Where is the central zone?

Answer 7

Surround the ejaculatory ducts

Question 8

What can form in the peripheral zone of the prostate?

Answer 8

Adenocarcinoma

Question 9

What is the peak age for prostate cancer?

Answer 9

70+

Question 10

True or False

There is no genetic link with prostate cancer

Answer 10

False.

Having a first degree relative with prostate Ca doubles the risk

Question 11

What is the presentation of prostate cancer?

Answer 11

Haematuria
Haematospermia
LUTS

Question 12

What highly sensitive but poorly specific test can be done for prostate cancer?

Answer 12

PSA

Question 13

What is the danger of using PSA as a prostate cancer marker?

Answer 13

Also raised if been instrumented or in infection or after DRE

Question 14

What may be observed on DRE in prostate cancer?

Answer 14

Asymmetrical craggy mass

Question 15

What must occur when testing a patient’s PSA?

Answer 15

Must be before a DRE

Must counsel patient as to results

Question 16

What is the next step with a positive PSA and abnormal DRE?

Answer 16

Trans-rectal USS guided prostate biopsy

Question 17

What is the main type of prostate cancer?

Answer 17

Adenocarcinoma

Question 18

Where does prostate cancer metastasise to?

Answer 18

Bone

Question 19

What is characteristic of prostate cancer on x-ray?

Answer 19

Sclerotic lesions on bone

Question 20

What grading score is done for prostate cancer?

Answer 20

Gleason’s scoring

1-5

Question 21

What are the treatment options for prostate cancer?

Answer 21

Watch and wait
Radical surgery
Radical radiotherapy
Androgen deprivation drugs

Question 22

True or False

Patient will definitely have ED after radical surgery

Answer 22

False.

Half of patients have ED

Question 23

True or False

Most of the body’s testosterone comes from the testis

Answer 23

True

Question 24

Why does androgen deprivation work as a therapy?

Answer 24

If androgens are suppressed for long enough prostate cells die without them

Question 25

How do LHRH agonists work?

Answer 25

Downregulate LHRH receptors so suppress LH and FSH to reduce testosterone production

Question 26

What are the side effects of LHRH agonists?

Answer 26

ED
Loss of libido
Weight gain
Gynaecomastia
Osteoporosis

Question 27

What is testosterone surge?

Answer 27

Transient rise in LH/FSH which causes testosterone production in first few weeks of LHRH agonist therapy

Question 28

How are LHRH agonists given?

Answer 28

Tablets
Injection
Implant

Question 29

How is testosterone surge avoided?

Answer 29

Anti-Androgen cover given for 1 week before LHRH injection

Question 30

How do anti-androgens work?

Answer 30

Compete with testosterone for binding sites, inhibiting prostate Ca growth.

Question 31

What are the two types of anti-androgens?

Answer 31

Steroidal

Non-steroidal

Question 32

Which anti-androgen type is preferable for younger or more sexually active men?

Answer 32

Non-steroidal as this maintains libido