prostate cancer Flashcards
Prevalence and mortality of prostate cancer
1 in 7 american men dx’d
1 out of 6 dx’d will die
RF’s for prostate CA
Strong family history
possible: environment, diet, high serum testosterone levels
Prostate CA responds to…
hormonal deprivation
What men do not develop prostate CA?
Men castrated before puberty
S/s of prostate cancer
early = none late = poss obstructive sxs later = metastatic sxs
When do you need to consider bx?
any hard nodule palpated on DRE
Any questionable nodule needs to be correlated w/…
PSA
Why do a DRE?
info about prostate
blood in the stool?
detects rectal cancer
How should you perform DRE?
pt in kneeling position
buttocks separated
use index finger for further penetration bc base of prostate more easily palpated
Nodules in the transition zone (20%) are…
Not palpable and asxs when small
nodules in the peripheral zone (70%) are…
palpable, asxs when small
why do a DRE?
Useful for approximating size of gland
Can detect cancers not identified by other methods
how is PSA produced?
by epithelial cells lining the acini and ducts of the prostate gland
How is PSA secreted?
in the seminal fluid, very little should enter the general circulation
Role of PSA in the body?
Liquefaction of the seminal coagulum
Where is PSA found?
in normal prostatic tissue, BPH tissue, and both primary and metastatic prostate cancer
What can cause benign elevation in PSA?
Acute urinary retention Benign prostatic hyperplasia Prostatitis Prostatic infarction Prostatic intraepithelial neoplasia (PIN) Instrumentation or catheterization
what is PSA velocity and what can it detect?
Change in PSA concentration over a period of time
detect early prostate cancer before detected by other methods
What is PSA density and why is it helpful?
= serum PSA concentration divided by prostate volume
helpful in differentiating prostate cancer from BPH
TorF: PSA is prostate CA specific?
FALSE. not
Is PSA following DRE accurate and reliable?
YAAAAS
What are genomic tests that can dx prostate CA?
PCA 3
4K Score
What MRI studies can dx prostate CA?
Multiparametric
PI-RADS score
Targeted fusion biopsy
What diagnostic tool can you use for prostate CA dx?
Transrectal Ultrasonography / Biopsy
