Prostate cancer

Question 1

Race with higher incidence of prostate cancer

Answer 1

Black

Question 2

Pathology of prostate cancer

Answer 2

Adenocarcinoma

Peripheral zone of prostate

Question 3

Presentation of prostate cancer

Answer 3

Usually asymptomatic
Mets: bone pain
Nocturia
Frequency
Hesitancy

Question 4

PR findings of prostate cancer

Answer 4

Hard irregular/craggy prostate

Loss of midline sulcus

Question 5

Common metastasis sites of prostate cancer

Answer 5

Bone

Rectum

Question 6

Ix for prostate cancer

Answer 6

PSA, U+Es
ALP
CXR
Bone scan
Transrectal US +/- biopsy

Question 7

Gleason grading system

Answer 7

Used to grade prostate cancer

Gleason score = Most common cell morphology + Second most common cell morphology

Question 8

Prostate cancer staging Tis

Answer 8

Carcinoma in situ

Question 9

Prostate cancer staging T1

Answer 9

Incidental finding on TURP or raised PSA

Question 10

Prostate cancer staging T2

Answer 10

Intracapsular tumour with prostate deformation

Question 11

Prostate cancer staging T3

Answer 11

Extra-prostatic extension

Question 12

Prostate cancer staging T4

Answer 12

Fixed to pelvis + invading neighbouring structures

Question 13

Conservative Mx of prostate cancer

Answer 13

Monitoring with PR and PSA

Question 14

Surgical Mx of prostate cancer

Answer 14

Radical Prostatectomy - robot laproscopically

Question 15

Medical Mx of prostate cancer

Answer 15

Used for metastatic or node +ve disease

Goserelin - LHRH analogue, reduce testosterone
Tamsulosin and finesteride

Question 16

Symptomatic management of prostate cancer

Answer 16

TURP for obstruction
Analgesia
Radiotherapy for bone mets / cord compression