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Fdnts 3 Exam 1 > prostate cancer > Flashcards

prostate cancer Flashcards

1
Q

Prevalence and mortality of prostate cancer

A

1 in 7 american men dx’d

1 out of 6 dx’d will die

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2
Q

RF’s for prostate CA

A

Strong family history

possible: environment, diet, high serum testosterone levels

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3
Q

Prostate CA responds to…

A

hormonal deprivation

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4
Q

What men do not develop prostate CA?

A

Men castrated before puberty

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5
Q

S/s of prostate cancer

A 
early = none
late = poss obstructive sxs
later = metastatic sxs
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6
Q

When do you need to consider bx?

A

any hard nodule palpated on DRE

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7
Q

Any questionable nodule needs to be correlated w/…

A

PSA

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8
Q

Why do a DRE?

A

info about prostate
blood in the stool?
detects rectal cancer

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9
Q

How should you perform DRE?

A

pt in kneeling position

buttocks separated

use index finger for further penetration bc base of prostate more easily palpated

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10
Q

Nodules in the transition zone (20%) are…

A

Not palpable and asxs when small

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11
Q

nodules in the peripheral zone (70%) are…

A

palpable, asxs when small

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12
Q

why do a DRE?

A

Useful for approximating size of gland

Can detect cancers not identified by other methods

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13
Q

how is PSA produced?

A

by epithelial cells lining the acini and ducts of the prostate gland

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14
Q

How is PSA secreted?

A

in the seminal fluid, very little should enter the general circulation

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15
Q

Role of PSA in the body?

A

Liquefaction of the seminal coagulum

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16
Q

Where is PSA found?

A

in normal prostatic tissue, BPH tissue, and both primary and metastatic prostate cancer

17
Q

What can cause benign elevation in PSA?

A 
Acute urinary retention
Benign prostatic hyperplasia
Prostatitis
Prostatic infarction
Prostatic intraepithelial neoplasia (PIN)
Instrumentation or catheterization
18
Q

what is PSA velocity and what can it detect?

A

Change in PSA concentration over a period of time

detect early prostate cancer before detected by other methods

19
Q

What is PSA density and why is it helpful?

A

= serum PSA concentration divided by prostate volume

helpful in differentiating prostate cancer from BPH

20
Q

TorF: PSA is prostate CA specific?

A

FALSE. not

21
Q

Is PSA following DRE accurate and reliable?

A

YAAAAS

22
Q

What are genomic tests that can dx prostate CA?

A

PCA 3

4K Score

23
Q

What MRI studies can dx prostate CA?

A

Multiparametric

PI-RADS score

Targeted fusion biopsy

24
Q

What diagnostic tool can you use for prostate CA dx?

A

Transrectal Ultrasonography / Biopsy

25
Q

Sxs of metastasis

A 
Bone pain
Weight loss
Anemia 
Azotemia
Fatigue
Dyspnea
Lymphedema
Ureteral obstruction
26
Q

What diagnostic tools should you order if suspicious for metastasis?

A

Nuclear Medicine Bone Scan
CT Abdomen and pelvis
PET

27
Q

Tx options

A

Surgical

Radiation (external beam, seed implantation)

Hormonal manipulation

Observation / Active

Surveillance

Newer options

28
Q

when should you do radical prostatectomy?

A

For lesions clinically confined to the prostate

29
Q

complications of Radical Prostatectomy

A

Impotence
Bladder neck contractures
Incontinence

30
Q

Hormonal manipulation can result in…

A

objective tumor regression measurable by bone scan, CT and PSA

31
Q

What are 3 examples of hormonal manipulation?

A

Bilateral orchiectomy
LH-RH Analogs
Antiandrogens

32
Q

What are LH-RH analog examples?

A

Leuprolide (Lupron, Eligard, Viadur)

Goserelin (Zoladex)

33
Q

common Side-effects of LH-RH analogs?

A

N/V/D, peripheral edema, gynecomastia, hot flashes

34
Q

Castrate Resistant Prostate Cancer Treatments examples

A 
Abiraterone (Zytiga)
Enzalutamide (Xtandi)
Sipuleucel-T (Provenge)
Docetaxel (Taxotere)
Cabazitaxel (Jevtana)
Radium-223
35
Q

What are 4 ways to dx prostate CA?

A

DRE
PSA
genomics
MRI

36
Q

3 ways to evaluate for mets?

A

Bone scan
CT
PET

37
Q

What are 4 tx options for prostate CA?

A

surgery
radiation
hormonal manipulation
observation

Fdnts 3 Exam 1 (17 decks)

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