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CCC > Prostate cancer > Flashcards

Prostate cancer Flashcards

1
Q

How common is prostate cancer?

A

Most common cancer in males

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2
Q

Who does prostate cancer affect?

A

50% of over 75s

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3
Q

How is prostate cancer caused?

A

Unknown aetiology
Associated with: Steroids, diet, radiation exposure, BRCA2, pTEN genes
May alter testosterone levels in the body

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4
Q

What does testosterone control?

A

Growth & function of the prostate

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5
Q

What is the histology of prostate cancer?

A

95% adenocarcinoma from glandular tissue in posterior/peripheral prostate

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6
Q

Where does BPH commonly arise?

A

Centre of the gland

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7
Q

How does prostate cancer present?

A

Asymptomatic
Prostatism: poor stream, nocturne, dribbling, inc frequency
Mets: pathological fractures

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8
Q

What is felt on prostate examination when considering cancer?

A

Enlarged
Hard
Craggy
Obliterated median sulcus

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9
Q

How is prostate cancer investigated?

A

Transrectal biopsy under USS sampling different parts

Bone mets: Radionuclide bone scan

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10
Q

Why is MRI a good test to use in prostate cancer?

A

Defines the extent of extra capsular spread

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11
Q

What are the options to manage prostate cancer?

A 
Observe
Surgery
RT
Hormone therapy
LHRH agonists
Oestrogen therapy
Chemo
Anti-androgens
Bilateral orchidectomy
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12
Q

How is surgery used to treat prostate cancer?

A

Localised disease

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13
Q

How is RT used to treat prostate cancer?

A 
Radical RT as alternative to surgery
T1/T2 tumours
PSA low
Control of more advanced local disease
Adjuvant following surgery
Definitive RT delayed till 6weeks post trans-urethral resection
External beam RT
Brachytherapy
Palliative: Palliate primary &/or treat mets
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14
Q

Describe brachytherapy in prostate cancer

A

Interstitial implantation of radioisotopes

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15
Q

How is hormone therapy used to treat prostate cancer?

A

Advanced disease
Inhibition of growth stimulatory effects of endogenous androgens
Neoadjuvant setting to downstage tumour

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16
Q

How does LHRH treat prostate cancer?

A

Interferes with the normal release of gonadotropins from the pituitary. This reduces the level of circulating testosterone
Goserelin & Buserelin
SE: impotence, loss of libido and tumour flare

17
Q

What is tumour flare?

A

LHRH treatment
On initiation of treatment
treated by short -term concomitant anti-androgen therapy

18
Q

How is oestrogen therapy used to treat prostate cancer?

A

Oestrogens inhibit LHRH production from the hypothalamus

SE: impotence, loss of libido, gynaecomastia, MI, CVAs & PE

19
Q

How is anti-androgen therapy used to treat prostate cancer?

A

Compounds compete with androgens for sites on the androgen receptor.
Megestrol
Bicalutamide

CCC (21 decks)

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