Prostate Cancer Flashcards
What percentage of prostate cancers are locally advanced or metastatic at diagnosis?
1/3
Risk factors for prostate cancer (4)
- Age: 63% of prostate cancers are diagnosed in men >65 y/o
- Race: AAs have 1.6x higher rate. More likely to present w/ aggressive disease, and more likely to die. Lowest risk in Asians and those from South America.
- Obesity associated w/ higher-risk disease. Higher risk w/ saturated fats, red mat, low fruits / veggies, low tomato products (lycopene), and low fish.
- High fiber diet decreases risk.
- High DHT
Typical presentation of prostate cancer
Most are asymptomatic
Sxs of localized disease
Most common sxs result from bladder outlet obstruction: hesitancy, nocturia, incomplete emptying, diminished urine stream.
Sxs of local advanced disease (3)
More significant bladder outlet obstruction, ED, pelvic pain.
Sxs of advanced disease (5)
Bone pain, neuro sxs (due to cord compression from vertebral metastases), weight loss, fatigue, pathologic fractures
In what part of the prostate do most cancers arise?
Peripheral zone
What are normal PSA levels?
0-4 ng/mL. Rise w/ age.
What things other than prostate cancer cause a rise in PSA? (5)
PSA elevated w/ prostatitis, prostate trauma (vigorous bike riding), ejaculation, BPH, and meds.
Screening recommendations
Annual DRE and PSA for men at “average risk” w/ life expectancy >10 years, starting at age 50. Start at age 45 if at high risk (AA or family hx in 2 first-deg relatives)
What imaging studies are done for prostate cancer?
Bone scan and CT
From which tissue are most prostate cancers derived from?
What kind of cancer?
Glandular epithelium
Adenocarcinoma
PIN
What is it?
Histology characteristics
Prostatic intraepithelial neoplasia
Characteristics include large nuclei, prominent nucleoli, and still contained.
Histological characteristics of adenocarcinoma (4)
Loss of basal cell layer, small / round / crowded glands, large cells, prominent nucleoli
4 options for treating localized disease
Active surveillance, radical prostatectomy, radiation, androgen deprivation therapy