prostate cancer Flashcards
what kind of carcinoma?
adenocarcinoma
where is the most common site of growth of prostate cancer?
Peripheral zone on posterior lobe
Local invasion occurs through the prostate into ?
o other pelvic tissue, especially bladder and seminal vesicles.
lymphatic spread?
sacral and iliac nodes
metastatic spread
bone, lungs and liver
what kind of lesions do bone mets cause?
osteosclerotic lesions
risk factors for prostate cancer?
age
family history
being black
when do LUTS start in prostate cancer compared to BPH?
later and less prominent because of position it starts
systemic symptoms of prostate cancer?
weight loss, night sweats, fever, back pain
on examination, what would the prostate feel like?
assymetrical, hard, craggy
normal range of PSA?
0-4
how many men with raised PSA will have prostate canceR
33%
what score is used as prognostic score?
gleason score
what is the gleason score out of? what score would be low risk, low grade cancer?
10
6
gleason 8-10?
high grade, high risk cancer
score of less than? indicate no malignant disease?
6
additional investigations (for mets and staging)
bone scan CT pelvis (for assessing size and lymphadenopathy) MRI pelvis (best for staging)
management of prostate cancer?
will depend on gleason score
- watchful waiting with PSA measurements
- radical prostatectomy (ED, urethral stricture and LUTS, incontinence)
- external beam radiotherapy (can be used as primary treatment or following surgery)
- Androgen deprivation (GNRH analogue: goserelin) (anti androgen: flutamide)
when is androgen deprivation used
used for more intermediate grade tumours and if there are positive lymph nodes
is prostate cancer radiosensitive?
can be used as a primary treatment or following surgery if positive margins are found
what age of patient would get prostatitis?
under 35
what organism is a causative organism of prostatitis?
e coli
which STIs can cause prostatitis?
chlamydia and gonorrhoea
presentation of prostatitis?
cystitis + flu like symptoms
low backache
urinary retention
haematospermia
on examination- prostatitis?
swollen, tender prostate on PR
Investigatons (same as epididymo orchidiits)
1st pass urine for chlamydia and gonorrhoea (PCR)
MSSU - UTI
1st line treatment of prostatitis
28 day quinolone treatment (ofloxacin or ciprofloxacin)
2 quinolone that are used in prostatitis?
ciprofloxacin and ofloxacin
in prostatitis, if high risk of c diff - what antibiotic can be used?
trimethoprim
