prostate cancer

Question 1

epidemiology of prostate cancer

Answer 1

2nd most comon cancer i men

black over white

Question 2

Risk factors for prostate cancer:

Answer 2

age, black, FHx, BRCA1and2, sexual activity (high frequency = decreased risk.

Question 3

ssx of prostate cancer

Answer 3

early = asymptomatic. locally advanced = bladder outlet obstruction, hematuria. UTI, irritative voiding. 
Disseminated disease (most often bone met): pain, pathological fractures.

Question 4

screening of prostate

Answer 4

Not recoomended, discuss w pts between 50-69. if risk factors = 40-45 yrs
if psa over 7 > do biposy, if psa between 4-7 = wait, new psa after a few weeks, if over 4 = do biposy, if abnormal DRE = biopsy.

Question 5

Biposy in prostate

Answer 5

USG guided, MRI guided, take minimum 132 cores, repeat biopsy if psa level continues to increase.

Question 6

staging of prostate cancer

Answer 6

TNM, adenocarcinoma, gleason scale. 1-5 (two of values)

Question 7

Low risk prostate cancer

Answer 7

Must have components of all groups: primary tumor: T1-2 a, psa less than 10, and gleason less than 6

Question 8

TX of low risk clinically localized Prostate cancer

Answer 8

RTH or RP, or active surveillance (pts with less than

Question 9

initial management of regionally localized intermediate and high risk prostate cancer

Answer 9

Intermediate w life expectancy over 10 yrs, high risk (in any life expectancy) = RTH or RP, intermediate risk with less than 10 yrs life expectancy: RTH or RP or ACTIVE SURVEILLANCE

Question 10

management of metastatic prostate cancer:

Answer 10

hormonal: 1st line!GNRH antagonist/agonist. or castration, can add chemo.
chemo: doxetaxel.
new durgs: abiraterone and enxalutamind, vaccine and radioisotope,