Prostate Cancer Flashcards
What are the 5 main Prostate cancer trials? some basics about the trials
PLCO, 76000, 55-74
ERSPC 180,000 55-69
Goteborg trial( subgroup analysis of Gottenberg) 20,000- 50-64 years old
CAP 400,000
Findings of PLCO?
annual PSA x 7 years
no difference in cancer specific survival
findings of ERSPC?
What about Goteberg?
-PSA q 4 years. 20% Relative risk of reduction in mortality
40% difference in mortality
PSA q 2 years
Findings of CAP?
no difference in mortality
Criticisms of PLCO
high levels of contamination in between arms.
high rates of pre-screening, non-adherence to biopsies
What 2 genes increase overall risk of prostate ca?
BRCA 1,2( particularly 2)
HOXB13
lynch syndrome MSH2
HPC( heridatry prostate cancer)
What are some of the risk factors of prostate cancer?
Family history, smoking,
What enzymes do finasteride and dutasteride affect?
finasteride: blocks type 2 ARI ( skin and prostate )
dutasteride blocks type 1 and 2 ARI
type 1 affects liver and other organs
What are some regulatory genes that are dmanged in prostate ca patients?
TP53, SPOP, and more
Describe PCPT trial?
Finasteride vs placebo Examine effects of finasteride in preventing pca 19,000 25% decrease in prostate ca 1.3% increase in high risk porstate ca
Describe REDUCE trial?
Dutasteride vs placebo
Examine effects of dutasteride in preventing Pca
8,200
25% decrease in Pca
1% or so increase in high risk prostate ca
Is 5-ARI recommended for prevention of Pca?
no, as per FDA it is not . currently no drugs are recommended for chemo-prevention.
Is 5-ARI recommended for prevention of Pca?
no, as per FDA it is not . currently no drugs are recommended for chemo-prevention.
What is PSA and What does PSA do ?
it is a serum protease that causes seminal fluid liquification. located on long arm of chrmosome 19. humal kalkrein 3. it is produced by prostatic luminal epithelial cells
What is PSMA?
prostate specific membrane antigen
on short arm of chromosme 11, deferentially expressed in cancer cells